Abstract
This study is a retrospective clinical audit to evaluate the impact of COVID-19 lockdown measures on the prevalence of obesity and hypertension in paediatric cardiology patients and determine the extent to which these comorbidities were recognised and managed at the East Midlands Congenital Heart Centre (EMCHC), UK. Height, weight and blood pressure (BP) values were extracted from clinic letters before and after COVID-19 lockdown at the EMCHC. BMI and BP percentiles were calculated to categorise BMI and BP stage. Analysis compared pre- and post-lockdown outpatient clinic data of paediatric cardiology patients. 800 patients were included. Mean BMI increased from 17 to 20 kg/m(2), with a 3% rise in obesity prevalence. South Asian children were the only ethnic group to show a significant post-lockdown increase in BMI percentile. Patients with severe congenital heart disease (CHD) had lower BMI than those with mild or repaired lesions. Although systolic and diastolic BP percentiles declined significantly post-lockdown (P < 0.001), 29% of patients met thresholds for stage 1 or stage 2 hypertension, likely an overestimate due to single automated readings and white-coat effects. BMI correlated positively with systolic BP in both periods (pre-lockdown r = 0.164; post-lockdown r = 0.297). Only 2% of hypertensive patients and 2% of patients with obesity were appropriately referred for further management. CONCLUSION: Obesity and hypertension remain under-recognised and undertreated in paediatric cardiology patients. Strong BMI-BP associations underscore the need for repeated manual BP readings, ambulatory monitoring and routine use of centile-based assessment to optimise long-term cardiovascular outcomes. WHAT IS KNOWN: • Childhood obesity and hypertension have increased globally, worsened by COVID-19 lockdowns. • Paediatric cardiac patients are especially vulnerable due to limited cardiac reserves and accelerated cardiovascular ageing. • These risks are often under-recognised in clinics. WHAT IS NEW: • Post-lockdown BMI and obesity rose particularly in South Asian children. • Hypertension was common yet seldom documented or acted upon. • Strong BMI-systolic BP correlations, disease-severity differences and missed referrals emphasise the need for percentile use, repeat BP checks and better integrated cardiometabolic pathways in paediatric cardiology.