Sir,

Re: Intervention for overweight and obese school children

The intention of Graf and her colleagues¹ was to prove the value of early preventive measures in obese children. Values for systolic blood pressure were higher in obese children compared to those of normal body weight. Intervention was shown to have a significant effect on systolic blood pressure. The study, however, fails to delineate specific effects in the subgroup of obese children with hypertension. It is not clear, indeed, whether the intervention had a positive effect.

The majority of obese children was normotensive, and the statistical mean of systolic blood pressure was normal for the whole group. Since obese children tend to be taller, it is no wonder that their blood pressure was higher. We presume that a maximum of 4 children amongst the 40 undergoing intervention were hypertensive. What effect did the intervention have on these 4? Most probably this particular group was too small for statistical analysis. The whole group showed a regression to the overall mean within the cohort of normotensive values, which is a well known statistical phenomenon.

Since the study outlines expensive measures for health care, it should be continued, hopefully to clarify whether hypertension in obese children can indeed be treated successfully by the proposed intervention.