Predicting hypertension using waist circumference in obese Indonesian adolescents

  • Elvietha Alamanda Department of Child Health,Gadjah Mada Univetsity Medical School/Dr. Sardjito Hospital, Yogyakarta, Central Java
  • Endy Paryanto Prawirohartono Department of Child Health,Gadjah Mada Univetsity Medical School/Dr. Sardjito Hospital, Yogyakarta, Central Java
  • Nenny Sri Mulyani Department of Child Health,Gadjah Mada Univetsity Medical School/Dr. Sardjito Hospital, Yogyakarta, Central Java
Keywords: waist circumference, hypertension, adolescent, obesity


Background Increasing prevalence of pediatric obesity and hypertension demonstrate the urgent need for early intervention. Waist circumference (WC) provides a measurement of central obesity, which has been specifically associated with cardiovascular risk factor including hypertension.

Objectives To identify the optimal cutô€€¹off point of we in predicting hypertension in obese adolescents.

Methods We randomly recruited 115 adolescents aged 12-17 years from schools in Yogyakarta, Central Java, Indonesia. We measured height, weight, WC, and blood pressure in 109 subjects. Optimum WC cut-offs to predict hypertension were determined using receiver-operating characteristic (ROC).

Results The optimum WC cut off point to predict any hypertension in adolescents was at the 88.95 cm with 97.8% sensitivity and 47.3% specificity. Ageô€€¹specific cutô€€¹off points for subjects < 15 year old was 90.1 cm with 91.7% sensitivity and 58%specificity, and for subjects 2: 15 year old was 103.5 cm with 75% sensitivity and 88% specificity.

Conclusions Waist circumference can be used to predict hypertension in obese adolescents with fair sensitivity and specificity. Waist circumference values associated with hypertension in adolescents vary with age and ethnicity.


1. Chaoyang L, Earl SF, AliHM, Cook S. Recent trends in waist circumference and waist􀁕height ratio among US children and adolescents. Pediatrics. 2006;118:1390-8.
2. Riset Kesehatan Dasar. Badan Penelitian dan Pengembangan Kesehatan. c2007 [cited 10 Feb 2009]. Available from httpJ/
3. Pinto A, Roldan R, Sollecito T. Hypertension in children: an overview. J Dent Educ. 2005; 704:34-8.
4. Savva SC, Tornaritis M, Savva ME, Kourides Y, Panagi A. Waist circumference and waist􀁕to􀁕height ratio are better predictors of cardiovascular disease risk factors in children than body mass index. Inter JObes. 2000;24:1453-8.
5. Eisenmann Jc. Waist circumference percentiles for 7 to 15-year-old Australian children. Acta Paediatr. 2005;94:1182-5.
6. Fernandez JR, Redden DT, Pietrobelli A, Alisson DB. Waist circumference percentiles in nationale representative samples of African-American, European-American, and Mexican-American Children and Adolescents. J Pediatr. 2004; 1454:39-44.
7. Fredriks AM, van Buuren S, Fekkes M, Verloove-Vanhorick SF, Wit JM. Are age references for waist circumference, hip circumference and waist-hip ratio in Dutch children useful in clinical practice? Eur J Pediatr. 2005;164:216-22.
8. Katzmarzyk PT. Waist circumference percentiles for Canadian youth 11-18 year of age. Eur J Clin Nutr. 2004;58:1011- 5.
9. McCarthy HD, Ellis SM, Cole TJ. Central overweight and obesity in British youth aged 11-16 years: cross sectional surveys of waist circumference. Br Med J. 2003;326:624.
10. Moreno LA, Fleta J, Mur L. Waist circumference values in Spanish children-gender related differences. Eur J Clin Nutr.1999;53:429-33.
11. Yan W, Yao H, Dai J, Cui J, Chen Y, Yang X, Harshfield GA. Waist circumference cut off points in school􀁒aged Chinese Han and Uygur children. Obesity. 2008;16:1687-92.
12. World Health Organization. Physical status: the use and interpretation of anthropometry: A report of a WHO Expert Committee. Geneva: WHO; 1995.
13. National high blood pressure education program working group on high blood pressure in children and adolescents. The fourth report on the diagnosis, evaluation and treatment of high blood pressure in children and adolescents.P ediatrics. 2004; 114:555-76.
14. Kanazawa M, YoshHke N, Osaka T, Numba Y, Zimmet P. Criteria and classification of obesity in Japan and Asia-Oceania. J Clin Nut. 2002;11:732-7.
15. Wildman RP, Gu D, Reynolds K, Duan X, He J. Appropriate body mass index and waist circumference cutoffs for categorization of overweight and central adiposity among Chinese adults. Am J Clin Nutr. 2004;80:1129.
How to Cite
Alamanda E, Prawirohartono E, Mulyani N. Predicting hypertension using waist circumference in obese Indonesian adolescents. PI [Internet]. 30Oct.2010 [cited 1Mar.2024];50(5):300-. Available from:
Received 2016-11-04
Accepted 2016-11-04
Published 2010-10-30