Relationship of body size and body mass to blood pressure: Sex-specific and developmental influences

The relationship of body mass and body fat distribution to blood pressure has been recognized for many years. This relationship has formed the basis for much additional research, including the impact of growth and developmental factors on blood pressure levels. Blood pressure in children is related to somatic growth and is tied to increases in height, skeletal maturation, and sexual maturation. Sexual and ethnic differences in blood pressure levels are already apparent during childhood and may also be related to the process of growth and sexual maturity. Body size exerts a profound influence on a variety of physiological functions, including blood pressure and the onset of sexual maturity. In general, studies have reported a strong linear relationship between height and blood pressure and between body mass and blood pressure such that tracking correlations from childhood to adulthood for both blood pressure and body mass index are significant for most sex and ethnic groups. Studies evaluating the effects of hormone replacement therapy on postmenopausal women have thus far generated results suggesting that the age-related rise of blood pressure is not due directly to hormonal changes associated with menopause. The interrelated effects of growth, maturation, body weight, and body fat are influenced by both genetic and environmental factors. Environmental influences may modify relationships established much earlier, perhaps as early as prenatally, during infancy, or during early childhood. Directions for future research and implications resulting from the complex relationship between body weight and blood pressure are discussed.