Observational Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. Sep 9, 2025; 14(3): 105939
Published online Sep 9, 2025. doi: 10.5409/wjcp.v14.i3.105939
Aerobic fitness, lipid ratio, visceral adiposity index and risk of hypertension in adolescents: An observational study
Danladi Ibrahim Musa, Daniel T Goon, Sunday Omachi, Sunday U Jonathan
Danladi Ibrahim Musa, Sunday Omachi, Department of Human Kinetics and Health Education, Kogi State University, Anyigba 272102, Kogi, Nigeria
Daniel T Goon, Faculty of Health Sciences, University of Limpopo, Sovenga 0727, South Africa
Sunday U Jonathan, Department of Human Kinetics and Health Education, Ibrahim Badamasi Babangida University, Lapai 911101, Niger, Nigeria
Author contributions: Musa DI conceived the study, analyzed the data and wrote the draft of the manuscript; Goon DT participated in data analysis, literature search and preparation of the manuscript; Omachi S participated in data collection, literature search, and proofread the manuscript; Jonathan SU participated in literature search and revised the manuscript critically for intellectual content, all authors have read and approved the final draft of the manuscript.
Institutional review board statement: The study was approved by the Ethical Review Committee of the College of Health Sciences, Kogi State University, Nigeria (Ref No: COHS/02/25/2020).
Informed consent statement: Written informed consent from parents/guardians and participants’ assent were obtained before data collection. All tests complied with the ethical guidelines outlined in the Helsinki Declaration as amended.
Conflict-of-interest statement: The authors have no conflict of interest.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement- checklist of items.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at dimusa55@gmail.com
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Danladi Ibrahim Musa, PhD, Professor, Department of Human Kinetics and Health Education, Ankpa Road, Kogi State University, Anyigba 272102, Kogi, Nigeria. musa.d@ksu.edu.ng
Received: February 11, 2025
Revised: March 25, 2025
Accepted: April 15, 2025
Published online: September 9, 2025
Processing time: 125 Days and 22.1 Hours
Abstract
BACKGROUND

Hypertension (HTN) is a significant global health concern due to its rising prevalence and associated risks of cardiovascular disease, chronic kidney disease, and other comorbidities. The increasing rates of HTN among youth have been partly attributed to the global rise in childhood obesity, lipid abnormalities, and sedentary lifestyles.

AIM

To investigate the independent associations of aerobic fitness (AF), the triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio, visceral adiposity index (VAI), and resting blood pressure (BP) in Nigerian adolescents.

METHODS

A multistage sampling technique was used to select 403 in-school adolescents aged 11-19 years in Kogi East, Nigeria. Participants were assessed for AF, TG/HDL-C ratio, VAI, systolic BP (SBP), and diastolic BP (DBP). The associations between the independent variables and the risk of systolic and diastolic HTN were examined using multivariate regression models, controlling for age and maturity status. Receiver operating characteristics curve (ROC) and area under the curve (AUC) were employed to determine the predictive capacities of the independent variables.

RESULTS

The overall prevalence of systolic HTN was 5.5% (girls: 7%; boys: 4%) while diastolic HTN was 12.7% (girls: 16.9%; boys: 8.4%). Among girls, all independent variables showed significant associations with SBP, including fitness (P < 0.001), TG/HDL-C (P < 0.001), and VAI (P < 0.001), with VAI showing the strongest association. In boys, all independent variables except VAI (P = 0.063) were significantly associated with SBP, with fitness showing the stronger predictive power (Fitness, P < 0.001; TG/HDL-C, P = 0.029). For DBP, all independent variables, except fitness in girls (P = 0.099), were significantly associated (P < 0.001) in both sexes. Unfit boys were 1.1 times more likely to develop systolic HTN (95%CI: 1.01–1.15, P = 0.018) and had 1.1 times higher odds of developing diastolic HTN (95%CI: 1.03–1.13, P = 0.001). Only the ROC for DBP turned up significant (P < 0.001) AUCs for TG/HDL-C and VAI in girls only, with 0.6 and 1.0 thresholds respectively.

CONCLUSION

AF, dyslipidemia, and visceral adipose tissue dysfunction were independently associated with the risk of HTN in Nigerian adolescents. These findings highlight the importance of promoting a healthy diet and encouraging aerobic physical activity among adolescents to reduce the risk of HTN.

Keywords: Adolescents; Abdominal adiposity; Cardiovascular health; Dyslipidemia; Fitness; Hypertension; Triglyceride-to-high-density lipoprotein cholesterol ratio

Core Tip: This study examined the independent associations of aerobic fitness (AF), the atherogenic index of plasma (AIP), and the visceral adiposity index (VAI) with resting blood pressure (BP), a key indicator of cardiovascular health. Adolescents with lower AF and elevated AIP and VAI were at an increased risk of HTN. Low fitness, dyslipidemia, and excessive visceral adipose tissue were independently associated with HTN risk. Notably, VAI exhibited a stronger association in girls, while fitness had greater impact in boys. Health promotion efforts should prioritize a balanced diet and regular endurance-based physical activity to support optimal BP levels in adolescents.