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Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics)

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Emotional stress as a risk factor of arterial hypertension in adolescents with obesity

https://doi.org/10.21508/1027-4065-2025-70-3-58-70

Abstract

The objective was to investigate the possible influence of emotional stress on the risk of hypertension and to evaluate its interaction with other risk factors in obese adolescents.

Material and methods. One hundred adolescents aged 12–17 years (mean age 13.9±2.2 years, 53 boys, 47 girls) with diagnosed constitutional-exogenous obesity (ICD-10 code: E66.0) were examined. The examination included the identification of arterial hypertension (AH) in accordance with accepted criteria. Adolescents were asked to fill out the Adolescent Stress Questionnaire (ASQ), designed to identify potential stressors and the level ofstress in various areas of the adolescent’s life and overall.

Results. Hypertension was diagnosed in 18% of adolescents, and as the degree of obesity increased, the frequency of hypertension statistically significantly increased. The maximum manifestations ofstress in adolescents were associated with attending school, peer pressure, and uncertainty about the future. Hierarchical logistic regression analysis revealed that the body mass index z-score at the time of examination, the overall severity of stress, and the age of patients at the time of examination had significant independent influences on the risk of hypertension, with the risk of hypertension increasing with higher values of these indicators. No significant association was found between the risk of hypertension and the gender of adolescents, the age of onset of excessive weight gain, and weight gain over the past year.

Conclusions. Emotional stress in adolescents with obesity is an independent additional risk factor for the development of hypertension. Psychological diagnosis and stress management should be one of the aspects ofreducing the risk of hypertension in adolescents with obesity.

About the Author

I. A. Kelmanson
Almazov National Medical Research Centre; Institute for Psychology and Social Work
Russian Federation

197341, Saint-Petersburg; 199178, Saint-Petersburg



References

1. Peterkova V.A., Bezlepkina O.B., Bolotova N.V., Bogova E.A., Vasyukova O.V., Girsh Ya.V., et. al. Clinical guidelines “Obesity in children”. Problemy jendokrinologii 2021; 67 (5): 67–83. (in Russ.). DOI: 0.14341/probl12802

2. Dakanalis A., Mentzelou M., Papadopoulou S.K., Papandreou D., Spanoudaki M., Vasios G.K., et. al. The Association of Emotional Eating with Overweight/Obesity, Depression, Anxiety/Stress, and Dietary Patterns: A Review of the Current Clinical Evidence. Nutrients 2023; 15 (5): 1–18. DOI: 10.3390/nu15051173

3. Aschbacher K., Kornfeld S., Picard M., Puterman E., Havel P.J., Stanhope K., et. al. Chronic stress increases vulnerability to diet-related abdominal fat, oxidative stress, and metabolic risk. Psychoneuroendocrinology 2014; 46: 14–22. DOI: 10.1016/j.psyneuen.2014.04.003

4. Himmelstein M.S., Incollingo Belsky A.C., Tomiyama A.J. The weight of stigma: cortisol reactivity to manipulated weight stigma. Obesity (Silver Spring) 2015; 23 (2): 368–374. DOI: 10.1002/oby.20959

5. Hudson L.D. Cardiovascular risk and stress in adolescents with obesity. UCL (University College London), 2018; 338 p

6. Амбатьелло Л.Г. Стресс-индуцированная артериальная гипертония. ТерАрх 2022; 94 (7): 908–913. DOI: 10.26442/00403660.2022.07.201733

7. Kelmanson I.A. Sleep quality, emotional and behavioral disturbances, and eating behavior in adolescents with obesity: a structural equation modeling. Somnologie 2023; 27 (2): 90–101. DOI: 10.1007/s11818–023–00405–8

8. Aleksandrov A.A., Kislyak O.A., Leontieva I.V., Rosanov V.B. Diagnostics, treatment and prevention of arterial hypertension in children and adolescents. Kardiovaskuljarnaja terapija i profilaktika 2009; 8 (4 S1): 1–32 (in Russ.). DOI: 10.15829/1728–8800–2009–4S1–3–32

9. Byrne D.G., Davenport S.C., Mazanov J. Profiles of adolescent stress: the development of the adolescent stress questionnaire (ASQ). J Adolesc 2007; 30 (3): 393–416. DOI: 10.1016/j.adolescence.2006.04.004

10. Falkner B. Monitoring and management of hypertension with obesity in adolescents. Integr Blood Press Control 2017; 10: 33–39. DOI: 10.2147/IBPC.S125094

11. Flynn J.T., Falkner B.E. Obesity hypertension in adolescents: epidemiology, evaluation, and management. J Clin Hypertens (Greenwich) 2011; 13 (5): 323–331. DOI: 10.1111/j.1751–7176.2011.00452.x

12. Cam H.H., Ustuner Top F. Prevalence of Hypertension and Its Association with Body Mass Index and Waist Circumference Among Adolescents in Turkey: A Cross-Sectional Study. J Pediatr Nurs 2021; 57: e29-e33. DOI: 10.1016/j.pedn.2020.09.017

13. Bloch K.V., Klein C.H., Szklo M., Kuschnir M.C., Abreu Gde A., Barufaldi L.A., et. al. ERICA: prevalences of hypertension and obesity in Brazilian adolescents. Rev Saude Publica 2016; 50(Suppl 1): 9s. DOI: 10.1590/S01518-8787.2016050006685

14. Guzzetti C., Pilia S., Ibba A., Loche S. Correlation between cortisol and components of the metabolic syndrome in obese children and adolescents. Journal of Endocrinological Investigation 2014; 37 (1): 51–56. DOI: 10.1007/s40618–013–0014–0

15. Ribeiro M.M., Silva A.G., Santos N.S., Guazzelle I., Matos L.N., Trombetta I.C., et. al. Diet and exercise training restore blood pressure and vasodilatory responses during physiological maneuvers in obese children. Circulation 2005; 111 (15): 1915–1923. DOI: 10.1161/01.CIR.0000161959.04675.5A

16. Ewart C., Kolodner K. Negative affect, gender, and expressive style predict elevated ambulatory blood pressure in adolescents. Journal of personality and social psychology 1994; 66 (3): 596–605. DOI: 10.1037//0022–3514.66.3.596

17. Ivanchenko V.S., Stylidis M.I., Gordienko A.I., Gagarina A.A., Ushakov A.V. Impact of psychoemotional stress and physical activity on endothelial function in hypertensive patients with obesity. Arterial’naja gipertenzija 2016; 22 (5): 456–465. (in Russ.). DOI: 10.18705/1607-419X-2016-22-5-456-465

18. Nagae A., Fujita M., Kawarazaki H., Matsui H., Ando K., Fujita T. Sympathoexcitation by Oxidative Stress in the Brain Mediates Arterial Pressure Elevation in Obesity-Induced Hypertension. Circulation 2009; 119: 978–986 DOI: 10.1161/CIRCULATIONAHA.108.824730

19. Mucci N., Giorgi G., De Pasquale Ceratti S., Fiz-Perez J., Mucci F., Arcangeli G. Anxiety, Stress-Related Factors, and Blood Pressure in Young Adults. Frontiers in Psychology 2016; 7: 1682. DOI: 10.3389/fpsyg.2016.01682

20. Lisco G., Giagulli V.A., De Pergola G., Guastamacchia E., Jirillo E., Vitale E., Triggiani V. Chronic Stress as a Risk Factor for Type 2 Diabetes: Endocrine, Metabolic, and Immune Implications. Endocrine, Metabolic & Immune Disorders-Drug Targets (Formerly Current Drug Targets-Immune, Endocrine & Metabolic Disorders) 2024; 24 (3): 321–332. DOI: 10.2174/1871530323666230803095118

21. Darjoko S.T., Ronoatmodjo S., Driyah S., Kristanti D., Tjandrarini D.H. Psychological distress and dyslipidemia in adult women: A 6-years follow up study in Bogor City, Indonesia. Universa Medicina 2022; 41 (3): 236–245. DOI: 10.18051/UnivMed.2022.v41.236–245

22. Li Y., Dong Y., Zou Z., Gao D., Wang X., Yang Z., et. al. Association between pubertal development and elevated blood pressure in children. J Clin Hypertens (Greenwich) 2021; 23 (8): 1498–1505. DOI: 10.1111/jch.14315

23. Quispe-Haro C., Pikhart H., Bobak M., Ksinan A.J. The relationship of puberty onset and blood pressure in children: a crosslagged panel analysis. European Journal of Preventive Cardiology 2024; 31(Suppl 1): i245. DOI: 10.1093/eurjpc/zwae175.169

24. Sebekova K., Gurecka R., Csongova M., Koborova I., Sebek J. Sex Differences in Association of Elevated Blood Pressure with Variables Characterizing Cardiometabolic Risk in Young Subjects with or Without Metabolic Abnormalities. Int J Environ Res Public Health 2020; 17 (10): 3612. DOI: 10.3390/ijerph17103612

25. Gordon B., Shamiss A., Derazne E., Tzur D., Afek A. Sex differences in the association between body mass index and hypertension — a cross-sectional study in 717 812 adolescents. Pediatr Obes 2016; 11 (4): 317–320. DOI: 10.1111/ijpo.12029.


Review

For citations:


Kelmanson I.A. Emotional stress as a risk factor of arterial hypertension in adolescents with obesity. Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics). 2025;70(3):58-70. (In Russ.) https://doi.org/10.21508/1027-4065-2025-70-3-58-70

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ISSN 1027-4065 (Print)
ISSN 2500-2228 (Online)