Hypertension and Obesity in Long Term Survivors of Childhood and Adolescent Cancer.

As a retrospective, single institution study of blood pressure and obesity in survivors of childhood and adolescent cancer, the records of 103 consecutive patients seen in a Long Term Follow Up Clinic from January 1 through June 30, 2004, were examined. Fifty-one patients (49.5%) were female, 52 (50.5%) male. The mean age was 14.6 yr, range 4–33 yr. Ethnic backgrounds were Caucasian 59 (57.3%), AfroAmerican 24 (23.3%), Hispanic 12 (11.6%), Asian 5 (4.9%), and MidEastern 3 (2.9%). Blood pressures for 1–17 yr of age were considered normal if the systolic or diastolic was <90 percentile, prehypertensive if 90–95 percentile, and hypertensive if ≥95 percentile for age, sex, and height. Blood pressures for 18 yr and older were considered prehypertensive if the systolic was 120–139 and/or the diastolic pressure 70–89, and hypertensive if the systolic was ≥140 and/or the diastolic pressure ≥90. Child and adolescent subjects were considered underweight if the BMI was <5 percentile, nonobese if <85 percentile, overweight if 85–97 percenntile, and obese if >97 percentile for age and sex. Adult subjects were considered underweight if the BMI was <18.5, nonobese if 18.5–24.9, overweight if 25–29.9, and obese if ≥30. A total of 29 (28.2%) patients were hypertensive or prehypertensive, and 74 (71.8%) were normal. A total of 38 (36.9%) patients were obese or overweight, 60 (58.3%) normal, and 5 (4.8%) underweight. Most Wilms’ tumor patients, 8 of 10 (80.0%), had hypertension or prehypertension, but only 4 of 10 (40.0%) were obese or overweight. Four of 5 (80.0%) patients with acute myeloid leukemia were obese or overweight, but only 2 of 5 (40.0%) had hypertension or prehypertension. Hispanic (75.0%) and AfroAmerican subjects (66.6%) were likely to be obese or overweight, but only 33.3% of both groups had hypertension or prehypertension. Although the number of study patients is small, our results emphasize the importance of identifying risk factors for hypertension and obesity in childhood and adolescent cancer survivors, particularly in survivors of Wilms’ tumor.