ArticleMedicine2026
Prevalence of hypertension in children evaluated for headache: The role of body mass index.
Article in Medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Headache is a common pediatric symptom with diverse etiologies, yet secondary causes such as hypertension are often overlooked. This study aimed to evaluate 24-hour ambulatory blood pressure monitoring (ABPM) findings in children presenting with headache and elevated office blood pressure (BP) and to examine the relationship between body mass index (BMI) and abnormal ABPM results. This retrospective study included 101 children aged 5 to 18 years who were referred for elevated office BP detected during headache evaluation. BMI percentiles were calculated using the CDC 2000 Growth Charts, and ABPM outcomes were compared among BMI categories. Among the 101 participants, 57 (56.4%) were male and 44 (43.6%) female, with a mean age of 14.3 ± 2.7 years. Based on BMI classification, 28 (27.7%) were normal weight, 20 (19.8%) overweight, and 53 (52.4%) obese. Mean age differed significantly among BMI groups (P < .05), with obese children being older than both normal-weight and overweight peers. Hypertension was identified in 8 (28.6%) normal-weight, 11 (55.0%) overweight, and 36 (67.9%) obese children. The prevalence of hypertension was significantly higher in obese compared with normal-weight participants (P < .05), whereas differences between normal-weight and overweight (P = .080) and between overweight and obese groups (P = .412) were not significant. Non-dipper status was also more frequent among obese children, showing a significant difference compared with normal-weight peers (P < .05). Pediatric obesity substantially increases the likelihood of abnormal ABPM findings in children presenting with headache, highlighting the importance of careful BP assessment. Elevated office BP in obese children should prompt timely ABPM to identify masked hypertension and reduce future cardiovascular risk.
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