Lower Bone Mineral Content in Hypertensive Compared With Normotensive Overweight Latino Children and Adolescents

Background In adults, hypertension has been shown to be inversely correlated with bone mineral content (BMC); however, the association between blood pressure (BP) and BMC has not been studied in pediatrics. Methods Total body BMC of 187 overweight (mean BMI = 28.7 kg/m2) Latino children and adolescents (mean age = 11.2 years) were measured using dual-energy x-ray absorptiometry. Seated systolic BP (SBP) and diastolic BP (DBP) were measured using a standard mercury sphygmomanometer. Hypertension was defined by SBP or DBP above the 90th percentile for height, age, and sex. Results Partial correlations revealed an inverse association between SBP and BMC (r = −0.24, P = 0.02) in boys (n = 105); results were nonsignificant (P = 0.27) in girls (n = 82). There were no significant correlations between DBP and BMC. When BMI and insulin sensitivity were adjusted for, hypertensive boys (n = 21) had lower BMC (1435 v 1636 g; P = 0.03) than normotensive boys (n = 84); similarly, hypertensive girls (n = 25) had lower BMC (1438 v 1618 g; P = 0.02) than normotensive girls (n = 57). In postpubertal adolescents (Tanner stage 4-5; n = 48), inverse correlations were stronger (r = −0.40, P = 0.007); results were nonsignificant in prepubertal and pubertal children (Tanner stage 1–3; n = 139, P = 0.57). In postpubertal girls (n = 37), there were no significant correlations (P = 0.14); inverse correlations in postpubertal boys (n = 11) became markedly stronger (r = −0.80, P = 0.02). Conclusion Based on the study findings, SBP is inversely correlated with BMC in overweight adolescents; additionally, hypertensive subjects have lower adjusted means of BMC than normotensive subjects. These promising new findings suggest that hypertension may be a risk factor for osteopenia in overweight children and adolescents; this risk may be exacerbated in postpubertal boys.