Raised body mass index and cardiovascular indices in secondary school students, South-South Nigeria

Bertilla U. Ezeonwu, Clifford O. Okike, Hyginus I. Opara, Leonard E. Abonyi, Obinna C. Ajaegbu, Efe E. Omoyibo, Ijeoma J. Nnodim, Ezinne Onyeka-Okite, Emeka Okoli, Angela A. Okolo


Background: Raised body mass index (obesity and overweight), is abnormal or excessive accumulation of fat that may impair health.The prevalence of obesity in Nigerian adolescents ranges between 1 and 10%.In children, raised body mass index is complicated with the development of cardiovascular diseases,which are consequences of arterial stiffness. The hallmark of arterial stiffness is wide pulse pressure which precedes isolated elevation of systolic blood pressure. Other manifestations of arterial stiffness are elevated diastolic blood pressure and increased mean arterial pressure. This study educated the students on healthy lifestyle and checked their cardiovascular indices.

Methods: This was a descriptive cross-sectional study of students. Their weight, height and blood pressure were measured and cardiovascular indices were calculated.

Results: There were 248 students, age between 8 and 16 years, 135 (54.4%) were males with adolescents comprising 96.8%. The prevalence rate of wide pulse pressure, raised body mass index, elevated blood pressure and increased mean arterial pressure was 26.6%, 16.1%, 8.5% and 4.0% respectively. More females and early adolescents comparably had raised body mass index.

Conclusions: The mean values for cardiovascular indices were comparably higher in those with raised body mass index.


Obesity, Blood, Pulse, Pressure, Arterial, Stiffness

Full Text:



World Health Organization. Obesity and Overweight. Fact sheet updated 2016. Accessed 13 August 2017.

Joint International Society of Nephrology (ISN) and the International Federation of Kidney Foundations (IFKF). Kidney Disease & Obesity: Healthy Lifestyle for Healthy Kidneys World Kidney Day 2017 fact sheet.

Ahmad MM, Ahmed H, Airede K. Body mass index among school adolescents in Sokoto, North-Western Nigeria. Sahel Med J. 2013;16:5-9.

Senbanjo IO, Oshikoya KA. Obesity and blood pressure levels of adolescents in Abeokuta, Nigeria. Cardiovasc J Afr. 2012;23:260–4.

Oduwole AA, Ladapo TA, Fajolu IB, Ekure EN, Adeniyi OF. Obesity and elevated blood pressure among adolescents in Lagos, Nigeria: a cross-sectional study. BMC Public Health. 2012;12:616.

Ujunwa FA, Ikefuna AN, Nwokocha ARC, Chinawa JM. Hypertension and prehypertension among adolescents in secondary schools in Enugu, South East Nigeria. Ital J Pediatr. 2013;39:70.

Ezeonwu BU, Nwafor I, Nnodim I, Ayodeji A, Ajaegbu O, Maduemem E et al. Risk factors for chronic kidney disease in children attending paediatric outpatient clinic in Federal Medical Center Asaba. J Prev Epidemiol. 2016;1(2):1-6.

Cote AT, Phillips AA, Harris KC, Sandor GGS, Panagiotopoulos C, Devlin AM. Obesity and Arterial Stiffness in Children Systematic Review and Meta-Analysis. Arterioscler Thromb Vasc Biol. 2015;35:1038-44.

García-Espinosa V, Curcio S, Castro JM, Arana M, Giachetto G, Chiesa P, et al. Children and Adolescent Obesity Associates with Pressure-Dependent and Age-Related Increase in Carotid and Femoral Arteries’ Stiffness and Not in Brachial Artery, Indicative of Nonintrinsic Arterial Wall Alteration. International Journal of Vascular Medicine. 2016;2016:4916246.

Cote AT, Harris KC, Panagiotopoulos C, Sandor GG, Devlin AM. Childhood obesity and cardiovascular dysfunction. J Am Coll Cardiol. 2013;62:1309–19.

Zieman SJ, Melenovsky V, Kass DA. Mechanisms, Pathophysiology, and Therapy of Arterial Stiffness. Arterioscler Thromb Vasc Biol. 2005;25:932-43.

Weisbrod RM, Shiang T, Al Sayah L, Fry JL, Bajpai S, Reinhart-King CA, et al. Arterial stiffening precedes systolic hypertension in diet-induced obesity. Hypertension. 2013;62:1105-10.

Zebekakis PE, Nawrot T, Thijs L, Balkestein EJ, van der Heijden-Spek J, Van Bortel LM, et al. Obesity is associated with increased arterial stiffness from adolescence until old age. J Hypertens. 2005;23:1839–46.

Zachariah JP, Graham DA, de Ferranti SD, Vasan RS, Newburger JW, Mitchell GF. Temporal Trends in Pulse Pressure and Mean Arterial Pressure During the Rise of Pediatric Obesity in US Children. J Am Heart Assoc. 2014;3:e000725.

Pierce GL, Zhu H, Darracott K, Edet I, Bhagatwala J, Huang Y, et al. Arterial stiffness and pulse-pressure ampli cation in overweight/obese African-American adolescents: relation with higher systolic and pulse pressure. Am J Hypertens. 2013;26:20–6.

Blacher J, Staessen JA, Girerd X, Gasowski J, Thijs L, Liu L, et al. Pulse pressure not mean pressure determines cardiovascular risk in older hypertensive patients. Arch Intern Med. 2000;160:1085–9.

Uwaezuoke S N, Okoli C V, Ubesie A C, Ikefuna A N. Primary hypertension among a population of Nigerian secondary school adolescents: Prevalence and correlation with anthropometric indices: A cross-sectional study. Niger J Clin Pract. 2016;19:649-54.

Hall ME, do Carmo JM, da Silva AA, Juncos LA, Wang Z, Hall JE. Obesity, hypertension, and chronic kidney disease. Int J Nephrol Renovasc Dis. 2014;7:75–8.

World Health Organization. Global strategy on diet, physical activity and health: Information sheet: global recommendations on physical activity for health 5-17 years. Accessed 5th September 2017.

Olusanya O, Okpere E, Ezimokhai M. The importance of social class in voluntary fertility control in a developing country. W Afr Med J. 1985;4:205-12.

National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents: fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004;114 (suppl 4th Report):555–76.

Cattermole GN, Leung PYM, Ho GYL, Lau PWS, Chan CPY, Chan SSW, et al. The normal ranges of cardiovascular parameters measured using the ultrasonic cardiac output monitor. Physiol Rep. 2017;5:e13195.

Forbes GB. Body composition. Growth in fat-free mass, fat mass and percent fat. In: Falkner F and Tanner JM eds. Human Growth: 2: Postnatal Growth: Bailliere Tindall London; 1978: 113–116.

Chandramohan G, Kalantar-Zadeh K, Kermah D, Go SCM, Vaziri ND, Norris KC. Relationship between obesity and pulse pressure in children: results of the National Health and Nutrition Survey (NHANES) 1988–1994. J Am Soc Hypertens. 2012;6:277–83.