School of Public Health

Ian Macumber

The Association of Pediatric Obesity with Nocturnal Non-Dipping on 24-Hour Ambulatory Blood Pressure Monitoring


Obesity has been linked with abnormal nocturnal dipping of blood pressure in adults, which in turn is associated with poor cardiovascular outcomes. There are few data regarding blood pressure dipping status in the obese pediatric population.


The goal of this study was to further describe the relationship between obesity and non-dipping status on ambulatory blood pressure monitor (ABPM) in children.


We conducted a cross-sectional study using a database of patients ages 5-21 years who had undergone 24-hour ABPM at Seattle Children's Hospital from January, 2008 through May, 2014. Subjects were grouped by BMI into non-obese (BMI 15th-85th percentile) and obese (BMI >95th percentile) groups.


Compared to non-obese subjects (n=161), those who were obese (n=247) had 2.15 times the prevalence of non-dipping, adjusted for race (95% confidence interval = 1.25-3.42). Increasing severity of obesity was not further associated with nocturnal non-dipping.


These results suggest that in children, just as in adults, obesity is related to a relatively decreased dipping in nocturnal blood pressure.