Association Between Muscle Mass Percentage and Blood Pressure in Children and Adolescents: A Cross-Sectional Study

Background. Excess adiposity is a well-established risk factor for elevated blood pressure in children. However, increasing evidence suggests that alterations in body composition, including reduced muscle mass and increased visceral fat, may also play an important role in the development of primary hypertension. Low muscle mass has been linked to arterial stiffness and increased cardiometabolic risk. Material and methods. A cross-sectional study was conducted in 1,002 children, of whom 715 had complete body composition data for primary analysis. Anthropometric measurements, body composition assessed by bioelectrical impedance analysis (BIA), and blood pressure measured using the oscillometric method were obtained. BP was assessed during one visit. Participants were categorized according to blood pressure status. Results. No significant differences were observed in body fat percentage between groups with different blood pressure levels (p = 0.363). In contrast, lower muscle mass percentage was significantly associated with higher blood pressure (p = 0.004). Similarly, lower total body water was associated with increased risk of hypertension (p = 0.004). Conclusions. Lower relative muscle mass, rather than increased body fat, was associated with elevated blood pressure. These findings highlight the potential role of muscle mass as a modifiable factor in the prevention of pediatric hypertension.