Obesity, hypertension, and mental health evaluation in adolescents: a comprehensive approach.

Full Abstract

The global epidemic of childhood and adolescent obesity in developing and developed countries has become a major public health concern. Given the relation between obesity and hypertension as documented in several landmark studies, it is no surprise that as the prevalence of obesity has increased in the pediatric population, the rates of hypertension have also increased substantially. Hypertension is one of the most important risk factors for cardiovascular diseases and stroke; therefore, evaluation and initiation of appropriate treatment are extremely important in the pediatric population. Evaluation for secondary causes of hypertension, including renovascular, renoparenchymal, and endocrine disease is the approach most commonly used in healthcare settings, with the goal to detect abnormalities that already have or might, if left unrecognized, affect the physical health of the child in the future. Children and adolescents are commonly evaluated for organic disease even in situations in which secondary hypertension is unlikely and overweight or obesity is most likely the primary factor contributing to hypertension. Psychological and psychosocial factors, which may play an important role in the etiology of obesity and related blood pressure elevation, are often addressed inadequately or completely ignored, potentially reducing long-term therapy success and increasing the incidence of avoidable complications. It is proposed that a comprehensive evaluation by a behavioral health provider will improve outcomes and potentially reduce long-term morbidity and hypertension-related end organ disease. A framework for mental health evaluation is provided.

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Author information

Author/s: Kiessling, Stefan G (SG); McClanahan, Kimberly K (KK); Omar, Hatim A (HA);

Affiliation: Division of Nephrology, Department of Pediatrics, Kentucky Children's Hospital, Lexington, Kentucky, United States.

Journal and publication information

Publication Type: Journal Article; Review

Journal: International journal of adolescent medicine and health (Int J Adolesc Med Health), published in England. (Language: eng)

Reference: -2008 Jan-Mar; vol 20 (issue 1) : pp 5-15

Dates: Created 2008/06/10; Completed 2008/07/29;

PMID: 18540279, status: MEDLINE (last retrieval date: 11/6/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adolescent
Female
Health Behavior
Humans
Hypertension - epidemiology; etiology; psychology

Kentucky - epidemiology
Male
Mental Health
Obesity - complications; epidemiology; psychology
Risk Factors

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