Open Access Open Badges Original investigation

Association between body size and blood pressure in children from different ethnic origins

Marieke LA de Hoog12*, Manon van Eijsden23, Karien Stronks1, Reinoud JBJ Gemke4 and Tanja GM Vrijkotte1

Author Affiliations

1 Department of Public Health, Academic Medical Centre, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, the Netherlands

2 Department of Epidemiology, Documentation and Health Promotion, Public Health Service, Amsterdam, the Netherlands

3 Institute of Health Sciences, VU University, Amsterdam, The Netherlands

4 Department of Paediatrics, EMGO institute, Institute of Cardiovascular Research, VU University Medical Centre, Amsterdam, the Netherlands

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Cardiovascular Diabetology 2012, 11:136  doi:10.1186/1475-2840-11-136

Published: 5 November 2012



To assess associations between body size and blood pressure in children (5-6 years) from different ethnic origins.


Five ethnic groups of the ABCD cohort were examined: Dutch (n=1 923), Turkish (n=99), Moroccan (n=187), Black-African (n=67) and Black-Caribbean (n=121). Data on body-mass-index (BMI), waist-to-height ratio (WHtR), fat-mass-index (FMI), and systolic blood pressure (SBP) and diastolic blood pressure (DBP), were collected. Linear regression analysis with restricted cubic splines was used to examine non-linear associations between body size and blood pressure, adjusted for age, sex, height and birth weight.


Ethnic differences were found in associations of BMI with SBP and DBP (SBP: p=0.001 and DBP: p=0.01) and FMI with SBP (p=0.03). BMI and FMI had a relatively large positive association with SBP in Turkish children (BMI: β=2.46mmHg; 95%CI:1.20-3.72; FMI: β=2.41mmHg; 95%CI:1.09-3.73) compared to Dutch (BMI: β=1.31mmHg; 95%CI:0.71-1.92; FMI: β=0.84mmHg; 95%CI:0.23-1.45). Black-Caribbean and Moroccan children showed high blood pressure with low BMI and FMI. Moroccan children showed higher SBP with high BMI and FMI. WHtR was positively associated with SBP and DBP, similar in all ethnic groups. Generally, strongest associations with blood pressure were found for BMI in all ethnic groups.


Ethnic-specific associations between BMI, and FMI and blood pressure are present at young age, with Turkish children showing the highest increase in blood pressure with increasing body size. The higher blood pressure in the Black-Caribbean and Moroccan children with low BMI needs further research. WHtR or FMI do not seem to be associated more strongly to blood pressure than BMI in any ethnic group.

Blood pressure; Ethnicity; Children; Adiposity; Body size