Researchers studied 245 overweight teenagers in China to understand how their body measurements and blood pressure affect their heart health. They used ultrasound to look at the thickness of blood vessel walls, which can show early signs of heart disease. The study found that high blood pressure was the strongest warning sign of potential heart problems in overweight teens. The good news is that controlling blood pressure early might help prevent serious heart disease later in life. This research suggests that doctors should pay special attention to blood pressure in overweight young people, not just their weight.

The Quick Take

  • What they studied: How body measurements, belly fat, and blood pressure connect to early signs of heart disease in overweight teenagers
  • Who participated: 245 obese teenagers from schools in Jiangsu Province, China, ranging from elementary through high school ages
  • Key finding: High blood pressure was the strongest predictor of thickened blood vessel walls (an early heart disease warning sign). Specific danger points were identified: systolic pressure above 115.7 mmHg and diastolic pressure above 70.9 mmHg for the right side, and higher thresholds for the left side.
  • What it means for you: If you’re an overweight teen or parent of one, getting blood pressure checked regularly is crucial. Managing blood pressure through exercise, reducing salt, and healthy eating may help prevent heart problems later. However, this study only looked at one moment in time, so more research is needed to confirm these findings.

The Research Details

This was a cross-sectional study, which means researchers took a snapshot of teenagers at one point in time rather than following them over years. They selected 245 overweight teenagers from schools across Jiangsu Province using a careful sampling method to ensure the group was representative. Each teenager had their height, weight, waist, and hip measurements taken. Doctors also measured their blood pressure and used ultrasound (the same technology used to see babies before birth) to look at the thickness of the walls in their neck blood vessels. This thickness is called carotid intima-media thickness, or cIMT, and it’s an early warning sign that heart disease might develop later.

This research approach is important because it helps identify which measurements doctors should focus on when checking overweight teenagers. By looking at many teenagers at the same time, researchers can spot patterns that might not be obvious from individual cases. The ultrasound measurements give doctors a way to see early heart damage before teenagers have actual heart attacks or strokes, making it possible to prevent serious problems.

The study used objective measurements (ultrasound and blood pressure machines) rather than relying on what people remember or report. The researchers used proper statistical methods to find real connections. However, because this is a snapshot study rather than following teenagers over time, we can’t be completely sure that high blood pressure causes the blood vessel changes—only that they occur together. The study was done in one Chinese province, so results might be slightly different in other populations.

What the Results Show

The most important finding was that blood pressure had the strongest connection to thickened blood vessel walls. Teenagers with higher systolic blood pressure (the top number) showed more thickening than those with lower pressure. The researchers found specific warning points: when systolic pressure went above 115.7 mmHg or diastolic pressure (bottom number) went above 70.9 mmHg on the right side of the neck, blood vessel walls started getting noticeably thicker. On the left side, the danger points were even higher: systolic above 131.0 mmHg and diastolic above 81.8 mmHg. Waist-to-hip ratio (how much fat is around the belly compared to the hips) also showed a connection, with problems increasing when the ratio exceeded 0.84. When researchers looked at all the measurements together using advanced statistics, only blood pressure remained strongly connected to blood vessel thickening—suggesting it’s the most important factor among those studied.

Body mass index (BMI) and waist-to-hip ratio both showed connections to blood vessel thickening when looked at individually. However, when researchers controlled for blood pressure, these measurements became less important. This suggests that blood pressure might be the main way that excess weight harms the heart, rather than weight itself being the direct problem. The study also found that different thresholds applied to the right and left sides of the neck, suggesting that heart damage might develop unevenly.

Previous research in adults has shown that obesity, belly fat, and high blood pressure all contribute to heart disease. This study confirms that these connections start appearing in teenagers, which is earlier than many doctors expected. The finding that blood pressure is more important than weight itself is somewhat surprising and suggests that overweight teenagers with normal blood pressure might have less immediate risk than previously thought. However, this contradicts some earlier studies, so more research is needed to clarify the picture.

This study only looked at teenagers at one moment in time, so we can’t prove that high blood pressure causes blood vessel thickening—only that they occur together. The study included only overweight teenagers, so results might not apply to teenagers of normal weight. All participants were from one province in China, so the findings might be different in other countries or ethnic groups. The study didn’t follow teenagers over time to see who actually developed heart disease, so we’re assuming that thickened blood vessels predict future problems based on adult research. Some important factors that affect heart health, like diet and exercise habits, weren’t measured in detail.

The Bottom Line

Overweight teenagers should have their blood pressure checked regularly (at least annually, or more often if elevated). If blood pressure is above normal for their age, lifestyle changes should be tried first: increasing physical activity to at least 60 minutes daily, reducing salt intake, eating more fruits and vegetables, and limiting sugary drinks. If lifestyle changes don’t work after 3-6 months, doctors may consider medication. These recommendations have moderate confidence because they’re based on this one study plus existing adult research, not yet on long-term studies of teenagers.

Overweight and obese teenagers should definitely pay attention to these findings. Parents of overweight teens should ensure regular blood pressure checks. Doctors treating overweight teenagers should prioritize blood pressure management. Teenagers of normal weight don’t need to worry about these specific thresholds, though maintaining healthy habits is always good. People with genetic conditions affecting blood pressure should work with their doctors on individual plans.

Blood pressure can start improving within weeks of lifestyle changes, though it usually takes 3-6 months to see significant drops. Blood vessel wall thickness changes more slowly—it might take 6-12 months or longer to see improvements on ultrasound. The real benefit comes over years and decades, as preventing early blood vessel damage reduces the risk of heart attacks and strokes in adulthood.

Want to Apply This Research?

  • Log blood pressure readings weekly (ideally at the same time each day), along with systolic and diastolic numbers. Set alerts when readings approach the danger thresholds identified in this study (115.7/70.9 mmHg for initial concern). Track trends over 4-week periods to see if lifestyle changes are working.
  • Set a daily activity goal of 60 minutes of moderate exercise (like brisk walking or cycling). Use the app to log exercise sessions and receive reminders. Create a sodium tracker to monitor salt intake, aiming for less than 2,300 mg daily. Log water intake and sugary drink consumption to help replace sodas with water.
  • Check blood pressure monthly and record in the app. Review 3-month trends to see if systolic and diastolic pressures are decreasing. If readings stay above 115/70 mmHg after 3 months of lifestyle changes, schedule a doctor visit. Continue monitoring even after improvements to prevent backsliding.

This research is informational and should not replace professional medical advice. If you are an overweight teenager or parent of one, consult with a doctor before making significant changes to diet or exercise routines, especially if there’s a family history of heart disease or high blood pressure. Blood pressure readings should be taken by trained healthcare professionals using proper equipment. This study shows associations between measurements but doesn’t prove cause-and-effect relationships. Individual results may vary based on genetics, overall health, and other factors not measured in this study.