To explore the relationship between the cumulative effect of overweight and obesity in children and the occurrence of elevated blood pressure, providing a basis for better prevention of hypertension in children.

Data were derived from the “Zigong School-Based Cardiovascular Metabolic Risk Cohort Study” conducted from 2012 to 2018. The survey included a questionnaire and physical examinations. The “overweight and obesity years” metric was calculated to assess the cumulative effect of overweight and obesity in children. Multivariable-adjusted linear regression and logistic regression models were employed to analyze the relationship between the cumulative effect of overweight and obesity, blood pressure levels and their changes, and the occurrence of elevated blood pressure.

The study included 1 637 children who were not hypertensive at baseline and had undergone at least four surveys, with an average age of 6.43 years, of which 50.00% were male. After an average follow-up of 4.57 years, 447 children developed elevated blood pressure, resulting in a cumulative incidence rate of 27.31%. During the follow-up, 381 children exhibited a cumulative effect of overweight and obesity (non-zero cumulative overweight and obesity years). The cumulative overweight and obesity years were positively correlated with endpoint systolic blood pressure, endpoint diastolic blood pressure, the difference between endpoint and baseline systolic blood pressure, and the difference between endpoint and baseline diastolic blood pressure (β₁=0.25, β₂=0.19, β₃=0.19, β₄=0.11, all P<0.05). Additionally, cumulative overweight and obesity years (OR=1.05, P<0.001),the degree of cumulative overweight and obesity (OR=1.04, P<0.001), and the duration of cumulative overweight and obesity (OR=1.14, P=0.014) were all positively correlated with the occurrence of elevated blood pressure in children.

The cumulative effect of overweight and obesity in children increases the risk of developing elevated blood pressure. Dynamic monitoring and timely intervention for overweight and obese children are crucial for preventing hypertension.