Parental overweight and hypertension are associated with their children's blood pressure

Background: We evaluated the association between parental factors (overweight, history of hypertension, and education level) and children's blood pressure status. Further, we evaluated to what extent the potential association could be interpreted by children's adiposity indices. Methods: The current study included 3316 Chinese school students (1579 girls and 1737 boys, aged 6-14 years) and their parents. Parents reported information on their height, body weight, history of hypertension, and the highest education level. Trained medical staff measured children's blood pressure, height, body weight, waist circumference (WC), and percentage of body fat (PBF, assessed by bio-impedance method). Z-score of all three indices were calculated and used in the analysis. We used generalized linear model to evaluate the association between parental information and z-score of children's blood pressure. Meditation analysis was used to evaluate the proportion contributed by z-score of children's adiposity indices (BMI, WC, and PBF). Results: We found that parental overweight and hypertension, but not parental education level, were significantly associated with children's systolic and diastolic blood pressure (P < 0.05 for all). Approximately 30.4-92.2% of the association between these two parental factors and children's systolic blood pressure were mediated by children's adiposity indices, and 22.3-55.6% for children's diastolic blood pressure. The strongest meditative factor, among the three obesity indices, was children's BMI z-score. Conclusions: The association between parental factors and children's blood pressure was mainly mediated by children's adiposity indices.