Obesity common in children with heart disease

NEW YORK (Reuters Health) - Among children born with congenital or acquired heart disease, more than one in four is overweight or obese, according to results of a study published in the journal Pediatrics.

"Obesity may pose additional cardiovascular risk to children with acquired and congenital heart disease," write Dr. Meryl S. Cohen, of Children's Hospital of Philadelphia, Pennsylvania, and colleagues. "Many children with heart disease are sedentary as a result of physician-, parent-, and/or self-imposed restrictions."

To estimate the prevalence of obesity and overweight in children with heart disease, the team performed a review of children seen at two cardiology outpatient clinics. They compared differences in the prevalence of obese (body mass index in the 95th percentile or higher) and overweight (body mass index the 85th to 95th percentile) children with the national average and healthy control subjects.

Among 1,523 children with heart disease, the authors identified five subgroups with different diagnosis, ranging from 401 with "mild" heart disease to 56 who underwent heart transplant.

Cohen and colleagues report that 26.2 percent of patients with any type of heart disease were overweight or obese. The prevalence of overweight and obese was significantly lower in healthy controls in all but 15.9 percent of the heart patients.

Among patients with any form of heart disease, systolic blood pressure (the top number of the blood pressure reading) was significantly higher in obese and overweight subjects compared to those with normal BMI.

Weight counseling was given to only 13.3 percent of obese patients and 8.7 percent of overweight patients.

"Appropriate interventions for obese pediatric cardiac patients need to be developed," Cohen and colleagues conclude. "Given the known benefits of normal weight and exercise participation, advising against inactivity, obesity, and other unhealthy lifestyle choices and communicating these concerns to the referring physician should be important parts of the pediatric cardiologist's care of children with cardiac disease."

SOURCE: Pediatrics, November 2007.