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Nsanya MK, Abramson R, Kisigo GA, Hickner A, Nyanza EC, Peck RN, Kapiga SH. Hypertension among adolescents in sub-Saharan Africa: a systematic review. Front Cardiovasc Med 2023; 10:1251817. [PMID: 38155990 PMCID: PMC10754047 DOI: 10.3389/fcvm.2023.1251817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 10/18/2023] [Indexed: 12/30/2023] Open
Abstract
Introduction Hypertension (HTN) among adolescents is common in high-income countries, and leads to increased premature cardiovascular diseases (CVD). In sub-Saharan Africa (SSA), the prevalence of HTN among adolescents, associated risk factors and CVD complications are not well-described. Such data is needed for planning public health programs to prevent premature CVD in SSA. Methods We systematically searched 5 databases (MEDLINE, Embase, Google Scholar, Web of Science, and African Index Medicus) from their establishment to December 2021. Key search terms were: adolescent, arterial hypertension, and names of the 48 countries in SSA. We used Covidence® to manage the search results. The review was registered in the Open Science Framework (OSF) https://osf.io/p5sbt/. Results We identified 4,008 articles out of which we screened 3,088 abstracts, and reviewed 583 full-text articles. We finally included 92 articles that were published between 1968 to December 2021. The majority were cross-sectional studies (80%) and conducted in school settings (78%). The risk of bias was low for 59 studies (64.1%), moderate for 29 studies (31.5%), and high for 4 studies (4.3%). Overall, the prevalence of HTN varied widely from 0.18% to 34.0% with a median (IQR) of 5.5% (3.1%, 11.1%). It was relatively higher in studies using automated blood pressure (BP) devices, and in studies defining HTN using thresholds based on percentile BP distribution for one's height, age, and sex. In addition, the prevalence of HTN was significantly higher in studies from Southern Africa region of SSA and positively correlated with the year of publication. Across studies, traditional risk factors such as age, sex, body mass index, and physical inactivity, were commonly found to be associated with HTN. In contrast, non-traditional risk factors related to poverty and tropical diseases were rarely assessed. Only three studies investigated the CVD complications related to HTN in the study population. Conclusion The prevalence of HTN among adolescents in SSA is high indicating that this is a major health problem. Data on non-traditional risk factors and complications are scarce. Longitudinal studies are needed to clearly define the rates, causes, and complications of HTN. Systematic Review Registration https://osf.io/p5sbt/, identifier (10.17605/OSF.IO/P5SBT).
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Affiliation(s)
- Mussa K Nsanya
- Mwanza Intervention Trials Unit/National Institute for Medical Research, Mwanza, Tanzania
| | - Rachel Abramson
- Weill Cornell Medicine - Cornell University, New York, NY, United States
| | - Godfrey A Kisigo
- Mwanza Intervention Trials Unit/National Institute for Medical Research, Mwanza, Tanzania
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Andy Hickner
- Weill Cornell Medicine - Cornell University, New York, NY, United States
| | - Elias C Nyanza
- Catholic University of Health and Allied Sciences, School of Public Health, Mwanza, Tanzania
| | - Robert N Peck
- Mwanza Intervention Trials Unit/National Institute for Medical Research, Mwanza, Tanzania
- Weill Cornell Medicine - Cornell University, New York, NY, United States
- Catholic University of Health and Allied Sciences, School of Public Health, Mwanza, Tanzania
| | - Saidi H Kapiga
- Mwanza Intervention Trials Unit/National Institute for Medical Research, Mwanza, Tanzania
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Chen A, Waite L, Mocumbi AO, Chan YK, Beilby J, Ojji DB, Stewart S. Elevated blood pressure among adolescents in sub-Saharan Africa: a systematic review and meta-analysis. Lancet Glob Health 2023; 11:e1238-e1248. [PMID: 37474231 DOI: 10.1016/s2214-109x(23)00218-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 04/28/2023] [Accepted: 04/28/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND More people from sub-Saharan Africa aged between 20 years and 60 years are affected by end-organ damage due to underlying hypertension than people in high-income countries. However, there is a paucity of data on the pattern of elevated blood pressure among adolescents aged 10-19 years in sub-Saharan Africa. We aimed to provide pooled estimates of high blood pressure prevalence and mean levels in adolescents aged 10-19 years across sub-Saharan Africa. METHODS In this systematic review and meta-analysis, we searched PubMed, Google Scholar, African Index Medicus, and Embase to identify studies published from Jan 1, 2010, to Dec 31, 2021. To be included, primary studies had to be observational studies of adolescents aged 10-19 years residing in sub-Saharan African countries reporting the pooled prevalence of elevated blood pressure or with enough data to compute these estimates. We excluded studies on non-systemic hypertension, in African people not living in sub-Saharan Africa, with participant selection based on the presence of hypertension, and with adult cohorts in which we could not disaggregate data for adolescents. We independently extracted relevant data from individual studies using a standard data extraction form. We used a random-effects model to estimate the pooled prevalence of elevated blood pressure and mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels overall and on a sex-specific basis. This study is registered with PROSPERO (CRD42022297948). FINDINGS We identified 2559 studies, and assessed 81 full-text studies for eligibility, of which 36 studies comprising 37 926 participants aged 10-19 years from ten (20%) of 49 sub-Saharan African countries were eligible. A pooled sample of 29 696 adolescents informed meta-analyses of elevated blood pressure and 27 155 adolescents informed meta-analyses of mean blood pressure. Sex data were available from 26 818 adolescents (14 369 [53·6%] were female and 12 449 [46·4%] were male) for the prevalence of elevated blood pressure and 23 777 adolescents (12 864 [54·1%] were female and 10 913 [45·9%] were male) for mean blood pressure. Study quality was high, with no low-quality studies. The reported prevalence of elevated blood pressure ranged from 4 (0·2%) of 1727 to 1755 (25·1%) of 6980 (pooled prevalence 9·9%, 95% CI 7·3-12·5; I?=99·2%, pheterogeneity<0·0001). Mean SBP was 111 mm Hg (95% CI 108-114) and mean DBP was 68 mm Hg (66-70). 13·4% (95% CI 12·9-13·9; pheterogeneity<0·0001) of male participants had elevated blood pressure compared with 11·9% (11·3-12·4; pheterogeneity<0·0001) of female participants (odds ratio 1·04, 95% CI 0·81-1·34; pheterogeneity<0·0001). INTERPRETATION To our knowledge, this systematic review and meta-analysis is the first systematic synthesis of blood pressure data specifically derived from adolescents in sub-Saharan Africa. Although many low-income countries were not represented in our study, our findings suggest that approximately one in ten adolescents have elevated blood pressure across sub-Saharan Africa. Accordingly, there is an urgent need to improve preventive heart-health programmes in the region. FUNDING None.
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Affiliation(s)
| | - Laura Waite
- Victorian Department of Health, Melbourne, VIC, Australia
| | - Ana O Mocumbi
- Faculty of Medicine, Universidade Eduardo Mondlane, Maputo, Mozambique; Instituto Nacional de Saúde, Marracuene, Mozambique
| | - Yih-Kai Chan
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Justin Beilby
- Torrens University Australia, Adelaide, SA, Australia
| | - Dike B Ojji
- Department of Internal Medicine, Faculty of Clinical Sciences, University of Abuja, Abuja, Nigeria; Cape Heart Institute, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Simon Stewart
- Faculty of Medicine, Universidade Eduardo Mondlane, Maputo, Mozambique; Cape Heart Institute, Department of Medicine, University of Cape Town, Cape Town, South Africa; Institute for Health Research, University of Notre Dame, Fremantle, WA, Australia.
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Babadi ME, Mansouri A, Nouri F, Mohammadifard N, Gharipour M, Jozan M, Rabiei K, Azarm T, Khosravi A. Morning Exercise at School and Sedentary Activities are Important Determinants for Hypertension in Adolescents. Int J Prev Med 2021; 12:131. [PMID: 34912507 PMCID: PMC8631126 DOI: 10.4103/ijpvm.ijpvm_41_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 01/03/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND This study was performed to determine the association of Pre-hypertension/hypertension (pre-HTN/HTN) with leisure-time activities and morning exercise at school in a sample of Iranian adolescents. METHODS This secondary study has done using data of 1992 adolescents participated in of Isfahan Healthy Heart Program. The outcome variable was having/not having pre-hypertension/hypertension (pre-HTN/HTN). The students with Blood pressure (BP) between 90th to 95th percentiles were considered as positive pre-HTN and students with BP >95th percentile were considered as positive HTN. Students with pre-HTN or HTN were considered as positive pre-HTN/HTN. The asked leisure-time activities were categorized in three group including first (ping-pong, basketball, and volleyball), second (football, walking, and bicycling) and sedentary activities (watching TV, studying, and computer gaming), using factor analysis. RESULTS The prevalence of pre-HTN and HTN was 16.1% and 6.7%, respectively. Based on multiple logistic regression pre-HTN/HTN was associated just with sedentary activities and morning exercise at school. Odds Ratio (95% confidence interval) for sedentary activities and morning exercise at school was 1.51 (1.13-2.01) and 0.63 (0.44-0.89), respectively. CONCLUSION We observed adolescents who engaged in morning exercise at school had lower prevalence of HTN while those who spent more times on sedentary activities were in higher risk for HTN. We suggest to permanent holding of morning exercise and educational programs on healthy lifestyle skills for adolescents by schools.
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Affiliation(s)
- Maryam Eghbali Babadi
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Asieh Mansouri
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Nouri
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Noushin Mohammadifard
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mojgan Gharipour
- Department of Metabolic Syndrome, Isfahan Cardiovascular Research Center, Isfahan University of Medicine Sciences, Isfahan, Iran
| | - Mahnaz Jozan
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Katayoun Rabiei
- Department of Metabolic Syndrome, Isfahan Cardiovascular Research Center, Isfahan University of Medicine Sciences, Isfahan, Iran
| | - Taleb Azarm
- Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Khosravi
- Interventional Cardiology Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Adeomi AA, Adelusi IO, Adedeji PO, Awofeso AE, Oroleye OO, Gbadegesin DL. Nutritional status and Cardiometabolic health among adolescents; findings from southwestern Nigeria. BMC Nutr 2019; 5:45. [PMID: 32153958 PMCID: PMC7050742 DOI: 10.1186/s40795-019-0308-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 08/29/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Obesity has been associated with an increased risk for cardio-metabolic diseases. The prevalence of obesity among adolescents is increasing worldwide, including Nigeria, but only little data exist on the relationship of nutritional status with cardio-metabolic health among adolescents in Nigeria. This study therefore investigated the relationship of nutrition status, raised blood pressure, glucose intolerance and risk for metabolic diseases among adolescents in southwestern Nigeria. METHODS This was a cross-sectional study conducted among 313 in-school adolescents in Ile-Ife, southwestern Nigeria. The respondents were selected using multi-stage sampling technique, and data were collected using pre-tested structured questionnaires. Anthropometric, blood pressure and random blood glucose measurements were done using standard protocols. Nutritional assessment was done using the World Health Organization (WHO) 2007 reference. Pre-hypertension and hypertension were measured using percentiles for gender, age and height. Analysis was done using IBM SPSS and the level of significance was set at p ≤ 0.05. RESULTS The mean age of the respondents was 14.4 ± 2.0 years. The prevalence of overweight and obesity was 10.2%, and it was significantly higher among females (12.5%) than males (7.0%). The prevalence of systolic and diastolic pre-hypertension was 10.9 and 11.5% respectively, while the prevalence for systolic and diastolic hypertension were 14.4 and 8.6% respectively. Using WHtR to assess cardio-metabolic risk, 7.3% of the respondents were at risk. There were statistically significant relationships between BMI, WHtR and blood pressure levels (< 0.05). CONCLUSIONS The prevalence of overweight/obesity among the adolescents was relatively high, and this was significantly associated with elevated blood pressure and increased risk for cardio-metabolic diseases. There is need for more interest and intervention by stakeholders into the cardio-metabolic health of adolescents in Nigeria.
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Affiliation(s)
- Adeleye Abiodun Adeomi
- Community Health Department, Obafemi Awolowo University, College of Health Sciences, Ile-Ife, Osun State Nigeria
| | - Iyanuoluwa Odunayo Adelusi
- Community Health Department, Obafemi Awolowo University, College of Health Sciences, Ile-Ife, Osun State Nigeria
| | - Praise Oluwatooni Adedeji
- Community Health Department, Obafemi Awolowo University, College of Health Sciences, Ile-Ife, Osun State Nigeria
| | - Adedoyin Esther Awofeso
- Community Health Department, Obafemi Awolowo University, College of Health Sciences, Ile-Ife, Osun State Nigeria
| | - Olajumoke Omotoyosi Oroleye
- Community Health Department, Obafemi Awolowo University, College of Health Sciences, Ile-Ife, Osun State Nigeria
| | - Doyinfunmi Lydia Gbadegesin
- Community Health Department, Obafemi Awolowo University, College of Health Sciences, Ile-Ife, Osun State Nigeria
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Amadi OF, Okeke IB, Ndu IK, Ekwochi U, Nduagubam OC, Ezenwosu OU, Asinobi IN, Osuorah CDI. Hypertension in Children: Could the Prevalence be on the Increase? Niger Med J 2019; 60:262-267. [PMID: 31844356 PMCID: PMC6900897 DOI: 10.4103/nmj.nmj_51_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 06/19/2019] [Accepted: 09/18/2019] [Indexed: 01/05/2023] Open
Abstract
Background In children particularly in the developing world, there is a tendency to downplay the role of primary hypertension in their health. In adults, a number of factors have clearly been associated with the incidence of hypertension. Knowledge of the prevalence of hypertension and its associated factors among children in our environment is important and could inform the need for lifestyle changes and routine blood pressure (BP) checks in children so as to reduce BP-related health risks. Aim The aim of this study is to document the prevalence of hypertension and its risk factors among children in Enugu, Nigeria. Materials and Methods Children aged 6-17 years attending the outpatient clinic of a tertiary hospital, were enrolled for the study. Their socioeconomic status (SES), weight, height, BP, and dipstick urinalysis were measured using standardized methods. Adherence to Mediterranean diet was assessed using the Mediterranean Diet Quality Index (KIDMED). The prevalence of hypertension and the influence of these factors on their BP were analyzed. Results Forty-six (9%) of the 491 participants had hypertension. Of these 46 hypertensive children, 72% were females while a significantly higher proportion 57% (P = 0.006), were in the age group 13-17 years. While age, gender, and the presence of protein in urine were significantly associated with hypertension in these children; body mass index, diet, family history of hypertension, and SES were not. Conclusion The prevalence of hypertension in children in this environment is high and appears to be increasing. There is need for routine BP and urinalysis check for all children in our clinics and wards.
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Affiliation(s)
- Ogechukwu F Amadi
- Department of Paediatrics, College of Medicine, Enugu State University of Technology, Enugu, Nigeria
| | - Ifenyinwa B Okeke
- Department of Paediatrics, College of Medicine, Enugu State University of Technology, Enugu, Nigeria
| | - Ikenna K Ndu
- Department of Paediatrics, College of Medicine, Enugu State University of Technology, Enugu, Nigeria
| | - Uchenna Ekwochi
- Department of Paediatrics, College of Medicine, Enugu State University of Technology, Enugu, Nigeria
| | - Obinna C Nduagubam
- Department of Paediatrics, College of Medicine, Enugu State University of Technology, Enugu, Nigeria
| | - Osita U Ezenwosu
- Department of Paediatrics, College of Medicine, Enugu State University of Technology, Enugu, Nigeria
| | - Isaac N Asinobi
- Department of Paediatrics, College of Medicine, University of Nigeria, Nsukka, Nigeria
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Pressão arterial elevada em escolares: fatores sociodemográficos e bioquímicos associados. Rev Port Cardiol 2019; 38:195-201. [DOI: 10.1016/j.repc.2018.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 06/11/2018] [Accepted: 06/24/2018] [Indexed: 11/30/2022] Open
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Reuter CP, Rodrigues ST, Barbian CD, Silveira JFDC, Schneiders LDB, Soares SS, Burgos LT, Burgos MS. High blood pressure in schoolchildren: Associated sociodemographic and biochemical factors. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2019. [DOI: 10.1016/j.repce.2018.06.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
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Ezeudu CE, Chukwuka JO, Ebenebe JC, Igwe WC, Egbuonu I. Hypertension and prehypertension among adolescents attending secondary schools in urban area of South-East, Nigeria. Pan Afr Med J 2018; 31:145. [PMID: 31037205 PMCID: PMC6462383 DOI: 10.11604/pamj.2018.31.145.15994] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 09/30/2018] [Indexed: 12/16/2022] Open
Abstract
Introduction in the past, the need for regular blood pressure screening in children was doubtful, and the main reason against it is that hypertension is an adult illness and there is no evidence that screening healthy children for hypertension was worthwhile. We did this study to determine the prevalence of hypertension and prehypertension as well as some risk factors for hypertension among secondary school adolescents in an urban area of the South-East, Nigeria. Methods this was a cross-sectional study of 984 adolescents aged 10-19 years in secondary schools in Awka South Local Government Area of Anambra state, South-East, Nigeria. The multi-stage sampling method was used to select the subjects. Data were collected from all eligible subjects with the aid of a questionnaire administered to them. Weight, height, and blood pressure were measured and recorded. Results nine hundred and eighty-four adolescents were recruited for this study, and they comprised 470 (47.8%) males and 514 (52.2%) giving a male: female ratio of 1:1.1. Their ages ranged from 10-19 years. The mean systolic blood pressure and mean diastolic BP were 110.5±10.2mmHg 71.5±8.5mmHg respectively. Prevalence of hypertension and pre-hypertension were 6.3% and 5.0% respectively. There were a higher proportion of females (7.3%) than males (5.4%) with hypertension, and more females (5.8%) than males (4.2%) with prehypertension but these were not statistically significant. Overweight and obesity were significantly associated with hypertension. Conclusion hypertension exists among secondary school adolescents in Awka South Local government area of Anambra state, with a prevalence of 6.3%. Early detection and treatment will forestall the early development of complications.
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Affiliation(s)
| | - John Onuora Chukwuka
- Department of Paediatrics, Nnamdi Azikiwe University, Awka, Nnewi Campus, Nigeria
| | - Joy Chinelo Ebenebe
- Department of Paediatrics, Nnamdi Azikiwe University, Awka, Nnewi Campus, Nigeria
| | | | - Ifeoma Egbuonu
- Department of Paediatrics, Chukwuemeka Odimegwu Ojukwu University Teaching Hospital, Awka, Anambra State, Nigeria
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Omisore AG, Omisore B, Abioye-Kuteyi EA, Bello IS, Olowookere SA. In-school adolescents' weight status and blood pressure profile in South-western Nigeria: urban-rural comparison. BMC OBESITY 2018; 5:2. [PMID: 29423239 PMCID: PMC5787246 DOI: 10.1186/s40608-018-0179-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 01/10/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND Obesity is a risk factor for hypertension. The study observed the relationship between adolescent weight status and blood pressure (BP) and the determinants of the BP pattern in urban and rural areas. METHODS This was a cross-sectional study of 1000 randomly selected respondents (500 from urban and 500 from rural areas) who had anthropometry and BP measurements done. The pattern of BP measurements based on the weight status by location was observed. Statistical inferences were drawn via Chi-square and logistic regression. RESULTS The mean age for all the respondents was 13.73 years ±2.04 (13.63 ± 2.05 for urban and 13.82 ± 2.03 for rural). Systolic and diastolic BP generally increased with increasing respondents' age, with mean pressures higher in urban areas. About 3% were obese, while 7.7% were overweight. The overall prevalence of high BP was 4.1%, with two-thirds coming from urban areas. On logistic regression analysis, the significant variables associated with high BP include being female (AOR 2.067, 95%CI1.007-4.243, p = 0.048), overweight (AOR 5.574, 95%CI 2.501-12.421, p = 0.0001) and obese (AOR 12.437, 95%CI 4.636-33.364, p = 0.0001). CONCLUSION High BP was associated with being female, overweight and obesity in both urban and rural areas. Urgent measures are needed to address increasing prevalence of overweight and obesity among adolescents and consequent high blood pressure.
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Affiliation(s)
| | - Bridget Omisore
- Department of Family Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Emmanuel Akintunde Abioye-Kuteyi
- Department of Family Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
- Department of Community Health, Obafemi Awolowo University Ile-Ife, Ile-Ife, Nigeria
| | - Ibrahim Sebutu Bello
- Department of Family Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Samuel Anu Olowookere
- Department of Community Health, Obafemi Awolowo University Ile-Ife, Ile-Ife, Nigeria
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Okpokowuruk FS, Akpan MU, Ikpeme EE. Prevalence of hypertension and prehypertension among children and adolescents in a semi-urban area of Uyo Metropolis, Nigeria. Pan Afr Med J 2017; 28:303. [PMID: 29854068 PMCID: PMC5966115 DOI: 10.11604/pamj.2017.28.303.14396] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 12/04/2017] [Indexed: 11/11/2022] Open
Abstract
Introduction In the past, Hypertension in childhood was not considered a problem but in the last few decades, it has gradually become a source of concern especially as children are known to maintain their blood pressures into adulthood. Therefore, hypertensive children are at risk of developing cardiovascular complications earlier in adulthood. In our own environment, the prevalence of hypertension in children is undocumented, hence the purpose of this study. Methods Two hundred children aged between 3-17 years were recruited into this study from two public schools-one primary, one secondary in a semi urban community in Uyo metropolis. The blood pressure of respondents was measured in accordance with the technique described by the 4th Task Force on Blood Pressure Control in Children. The height and weight of all eligible subjects was measured using a stadiometer and a calibrated scale respectively. Body Mass Index (BMI) was assessed for each subject and World Health Organization (WHO) charts of BMI for age and sex were used as reference standards. Waist circumference was measured according to the technique described in the National Health and Nutrition Examination Survey. Results The prevalence of hypertension and prehypertension was found to be 3.5% and 2.5% respectively in this study. Only age (OR = 1.74, p = 0.005, 95%CI = 1.186-2.566), BMI (OR = 1.54, p = <0.001, 95% CI = 1.249-1.913) and waist circumference (OR = 1.16, p = 0.002, 95%CI = 1.056-1.271) were found to significantly predict the development of high blood pressure. Conclusion The prevalence of hypertension and prehypertension in this study was found to be low. Hypertension/prehypertension was more likely to develop with increasing age, BMI and waist circumference.
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Affiliation(s)
- Frances Sam Okpokowuruk
- Department of Paediatrics, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria
| | - Mkpouto Udeme Akpan
- Department of Paediatrics, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria
| | - Enobong Emmanuel Ikpeme
- Department of Paediatrics, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria
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Prevalence of elevated blood pressure in children and adolescents in Africa: a systematic review and meta-analysis. LANCET PUBLIC HEALTH 2017; 2:e375-e386. [PMID: 29253478 DOI: 10.1016/s2468-2667(17)30123-8] [Citation(s) in RCA: 106] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 06/04/2017] [Accepted: 06/09/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND Despite substantial attention paid to the threat of elevated blood pressure in children and adolescents in high-income countries and the epidemic of hypertension in African adult populations, data on the burden of elevated blood pressure in African children and adolescents have not yet been synthesised. We did a systematic review and meta-analysis to provide estimates of the prevalence of elevated blood pressure and assess associated factors among children and adolescents in Africa. METHODS We searched Embase, PubMed, African Journals Online, and African Index Medicus to identify articles published from Jan 1, 1996, to Feb 2, 2017, and searched the reference list of retrieved articles. Each study was independently reviewed for methodological quality. We used a random-effects model to estimate the prevalence of elevated blood pressure across studies and heterogeneity (I2) was assessed via the χ2 test on Cochran's Q statistic. This review is registered with PROSPERO, number CRD42015019029. FINDINGS We included 51 studies in qualitative synthesis and 25 in the meta-analysis reporting data of a pooled sample of 54 196 participants aged 2-19 years. Study quality was high with only four medium-quality studies and no low-quality studies. Prevalence of elevated blood pressure varied widely across studies (range 0·2-24·8%). The pooled prevalence of elevated blood pressure (systolic or diastolic blood pressure ≥95th percentile) was 5·5% (95% CI 4·2-6·9), whereas that of slightly elevated blood pressure (systolic or diastolic blood pressure ≥90th percentile and <95th percentile) was 12·7% (2·1-30·4). The prevalence of elevated blood pressure was largely associated with body-mass index (BMI), with a prevalence of elevated blood pressure six times higher in obese (30·8%, 95% CI 20·1-42·6) versus normal-weight children (5·5%, 3·1-8·4; p<0·0001). INTERPRETATION This study suggests a high prevalence of elevated blood pressure among children and adolescents in Africa, with overweight and obesity being an important risk factor. Efforts to address this burden of elevated blood pressure in children and adolescents should mainly focus on primary prevention at the community level, by promoting healthy lifestyles and avoiding other cardiovascular risk factors, especially overweight and obesity. This study also stresses the need for more elaborate studies using uniform and reliable diagnostic methods to reliably map the burden of elevated blood pressure in children and adolescents in Africa. FUNDING None.
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Anthropometric Indices in the Prediction of Hypertension in Female Adolescents. IRANIAN RED CRESCENT MEDICAL JOURNAL 2017. [DOI: 10.5812/ircmj.14591] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Ejike CECC. Prevalence of Hypertension in Nigerian Children and Adolescents: A Systematic Review and Trend Analysis of Data from the Past Four Decades. J Trop Pediatr 2017; 63:229-241. [PMID: 28082664 DOI: 10.1093/tropej/fmw087] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Despite four decades of research, there is no systematic review and trend analysis on paediatric (pre)hypertension in Nigeria. This article reviewed data from cross-sectional studies on the subject. From the initial 9334 articles identified, 30 studies that met the inclusion criteria were systematically reviewed. Data from studies that defined hypertension as blood pressure (BP) greater than the 95th percentile for age, height and sex gave a prevalence of 8.2% [95% confidence interval (CI): 3.6-28.2%] for prehypertension and 5.1% (95% CI: 2.9-8.6%) for hypertension. For studies that defined hypertension as BP greater than 2 SD points from the mean of the population, the prevalence of hypertension was found to be 4.0% (95% CI: 2.8-5.7%). A significant negative trend (Z = -0.89; α < 0.01) with small magnitude (Q = -0.019; 95% CI: -0.070 to 0.028) was found for hypertension in the reviewed population. The prevalence of (pre)hypertension in Nigerian children and adolescents is moderate but has slightly declined over time.
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Affiliation(s)
- Chukwunonso E C C Ejike
- Department of Medical Biochemistry, Faculty of Basic Medical Sciences, Federal University Ndufu-Alike, Ikwo, PMB 1010 Abakaliki, Ebonyi State, Nigeria
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Odunaiya NA, Louw QA, Grimmer KA. Are lifestyle cardiovascular disease risk factors associated with pre-hypertension in 15-18 years rural Nigerian youth? A cross sectional study. BMC Cardiovasc Disord 2015; 15:144. [PMID: 26537355 PMCID: PMC4632346 DOI: 10.1186/s12872-015-0134-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Accepted: 10/25/2015] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is a public health concern worldwide. Hypertensive heart disease is predominant in Nigeria. To effectively reduce CVD in Nigeria, the prevalence of, and factors associated with, pre-hypertension in Nigerian youth first need to be established. METHODS A locally-validated CVD risk factor survey was completed by 15-18 year olds in a rural setting in south-west Nigeria. Body Mass Index (BMI), waist-hip ratio and systolic and diastolic blood pressure was measured. Putative risk factors were tested in gender-specific hypothesized causal pathways for overweight/obesity, and for pre-hypertension. RESULTS Of 1079 participants, prevalence of systolic pre-hypertension was 33.2 %, diastolic pre-hypertension prevalence approximated 5 %, and hypertension occurred in less than 10 % sample. There were no gender differences in prevalence of pre- hypertension, and significant predictors of systolic pre-hypertension (high BMI and older age) were identified. Considering high BMI, older age was a risk for both genders, whilst fried food preference was female-only risk, and low breakfast cereal intake was a male-only risk. CONCLUSION Rural Nigerian adolescents are at-risk of future CVD because of lifestyle factors, and high prevalence of systolic pre-hypertension. Relevant interventions can now be proposed to reduce BMI and thus ameliorate future rural adult Nigerian CVD.
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Affiliation(s)
- N A Odunaiya
- Division of Physiotherapy, Stellenbosch University, Cape Town, South Africa.
- Department of Physiotherapy, University of Ibadan, Ibadan, Nigeria.
| | - Q A Louw
- Division of Physiotherapy, Stellenbosch University, Cape Town, South Africa.
| | - K A Grimmer
- Division of Physiotherapy, Stellenbosch University, Cape Town, South Africa.
- International Center for Allied Health Evidence, University of South Australia, Adelaide, Australia.
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Akinlua JT, Meakin R, Umar AM, Freemantle N. Current Prevalence Pattern of Hypertension in Nigeria: A Systematic Review. PLoS One 2015; 10:e0140021. [PMID: 26461923 PMCID: PMC4603956 DOI: 10.1371/journal.pone.0140021] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 09/19/2015] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The global burden of hypertension and other non-communicable diseases (NCDs) is rapidly increasing, and the African continent seems to be the most affected region in the world. The prevalence of hypertension in Nigeria forms a substantial portion of the total burden in Africa because of the large population of the country currently estimated to be over 170 million. OBJECTIVE The purpose of this systematic review is to summarise up to date data on the prevalence and distribution of hypertension in Nigeria from prevalence studies. METHODS A search of the following databases: PubMed, EMBase and WHO cardiovascular InfoBase from 1968 till date was conducted to identify studies which provide estimates of prevalence of hypertension in Nigeria. RESULTS The search yielded a total of 1748 hits from which 45 relevant studies met the inclusion criteria for the review. The overall crude prevalence of hypertension ranged from 0.1% (95%CI:-0.1 to 0.3) to 17.5% (95% CI: 13.6 to 21.4) in children and 2.1% (95%CI: 1.4 to 2.8) to 47.2% (95%CI: 43.6 to 50.8) in adults depending on the benchmark used for diagnosis of hypertension, the setting in which the study was conducted, sex and ethnic group. The crude prevalence of hypertension ranged from 6.2% (95%CI: 4.0 to 8.4) to 48.9% (95%CI: 42.3 to 55.5) for men and 10% (95%CI: 8.1 to 12) to 47.3% (95%CI: 43 to 51.6%) for women. In most studies, prevalence of hypertension was higher in males than females. In addition, prevalence across urban and rural ranged from 9.5% (95%CI: 13.6 to 21.4) to 51.6% (95%CI: 49.8 to 53.4) and 4.8% (95%CI: 2.9 to 6.7) to 43% (95%CI: 42.1 to 43.9) respectively. CONCLUSIONS The prevalence of hypertension is high among the Nigerian population. Appropriate interventions need to be developed and implemented to reduce the preventable burden of hypertension especially at Primary Health Care Centres which is the first point of call for over 55% of the Nigerian population.
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Affiliation(s)
- James Tosin Akinlua
- Department of Primary Care and Population Health, University College London Medical School (Royal Free Campus), Rowland Hill street, London, NW3 2PF, United Kingdom
| | - Richard Meakin
- Department of Primary Care and Population Health, University College London Medical School (Royal Free Campus), Rowland Hill street, London, NW3 2PF, United Kingdom
| | - Aminu Mahmoud Umar
- College of Science and Technology, University of Salford, Salford Crescent, Manchester, M5 4WT, United Kingdom
| | - Nick Freemantle
- Department of Primary Care and Population Health, University College London Medical School (Royal Free Campus), Rowland Hill street, London, NW3 2PF, United Kingdom
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Kuciene R, Dulskiene V, Medzioniene J. Association of neck circumference and high blood pressure in children and adolescents: a case-control study. BMC Pediatr 2015; 15:127. [PMID: 26383844 PMCID: PMC4574610 DOI: 10.1186/s12887-015-0444-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 09/09/2015] [Indexed: 01/03/2023] Open
Abstract
Background High blood pressure (BP) is a serious, common and growing global public health problem. The aim of this study was to evaluate the associations between high NC (neck circumference) alone and in combinations with BMI (body mass index), WC (waist circumference), and high BP among Lithuanian children and adolescents aged 12 to 15 years. Methods An epidemiological case–control study was performed between May 2012 and November 2013. NC, WC, hip circumference (HC), mid-upper arm circumference (MUAC), body height, weight, and BP were measured. The participants with high BP (≥90th percentile) were screened on two separate occasions. Data on NC, WC, HC, MUAC, BMI, body adiposity index (BAI), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), and BP were analyzed in 1947 children and adolescents aged 12–15 years. Age- and sex-adjusted odds ratios (aORs) with 95 % confidence intervals (CI) for the associations were estimated using multivariate logistic regression models. Results The prevalence rates of prehypertension (BP ≥90th– < 95th percentile) and hypertension (BP ≥95th percentile) was 6.3 and 25.1 %, respectively. The overall prevalence of high NC (if NC was in the ≥90th percentile), overweight/obesity (as measured by BMI), and abdominal overweight/obesity (if WC was in the ≥75th percentile) were 14.3, 15.8, and 13 %, respectively. After adjustment for age and sex, NC in the ≥90th percentile was significantly associated with an increased risk of elevated BP (prehypertension: aOR = 2.99; 95 % CI, 1.88–4.77; hypertension aOR = 4.05; 95 % CI, 3.03–5.41, and prehypertension/hypertension aOR = 3.75; 95 % CI, 2.86–4.91), compared to the participants with NC in the <90th percentile. Overweight/obesity and abdominal overweight/obesity were also significantly associated with an elevated BP. The combinations including both risk factors (high NC with overweight/obesity, and high NC with abdominal overweight/obesity) showed higher aORs than those with either risk factor alone. Conclusions High NC alone—but particularly in combinations with overweight/obesity and abdominal overweight/obesity—was associated with an increased risk of high BP.
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Affiliation(s)
- Renata Kuciene
- Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukileliu ave. 17, LT-50009, Kaunas, Lithuania.
| | - Virginija Dulskiene
- Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukileliu ave. 17, LT-50009, Kaunas, Lithuania.
| | - Jurate Medzioniene
- Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukileliu ave. 17, LT-50009, Kaunas, Lithuania.
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Ferretti RDL, Cintra IDP, Passos MAZ, de Moraes Ferrari GL, Fisberg M. Elevated neck circumference and associated factors in adolescents. BMC Public Health 2015; 15:208. [PMID: 25880196 PMCID: PMC4351829 DOI: 10.1186/s12889-015-1517-8] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Accepted: 02/10/2015] [Indexed: 12/11/2022] Open
Abstract
Background Upper body subcutaneous fat, estimated by neck circumference (NC), may present greater metabolic risk than visceral fat. The aim of this study was to determine cutoff values for NC in adolescents that identify overweight and obesity, the prevalence of elevated NC, and its association with associated factors. Methods Cross-sectional study with adolescents from public schools in São Paulo. Anthropometric variables, blood pressure and pubertal stage were collected. Cutoff values for NC were determined by Receiver Operating Characteristic curves. A binary logistic regression was used to determine relationships between NC and associated factors. Results Among 1668 adolescents studied, 54.92% were female. The cutoff values of NC in girls and boys that identified overweight were 31.25 and 34.25 cm, and obesity, 32.65 and 37.95 cm, respectively, and the prevalence of adolescents with high NC was 32.63% in females and 37.63% among males. NC for overweight was observed that there was an association with sex, weight, body mass index, arm, waist and thigh circumferences, pubertal stages and body fat percent (BF%). NC for obesity was found association with gender, weight, arm and thigh circumferences, and BF% (p < 0.001). Conclusion It was concluded that there is high prevalence of elevated NC and higher risks for this outcome considering overweight and obesity, sex, weight, arm and thigh circumferences, BF%, besides being an easy and simple measure for use in clinical practice.
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Affiliation(s)
- Roberta de Lucena Ferretti
- Adolescent Medicine Sector (Adolescent Care and Support Center) of the Pediatrics Department of the Federal University of São Paulo, São Paulo, Brazil. .,Department of Nursing and Nutrition of the Taubate University, São Paulo, Brazil.
| | - Isa de Pádua Cintra
- Adolescent Medicine Sector (Adolescent Care and Support Center) of the Pediatrics Department of the Federal University of São Paulo, São Paulo, Brazil.
| | - Maria Aparecida Zanetti Passos
- Adolescent Medicine Sector (Adolescent Care and Support Center) of the Pediatrics Department of the Federal University of São Paulo, São Paulo, Brazil.
| | - Gerson Luis de Moraes Ferrari
- Adolescent Medicine Sector (Adolescent Care and Support Center) of the Pediatrics Department of the Federal University of São Paulo, São Paulo, Brazil. .,Center for Physical Fitness Laboratory Studies of São Caetano do Sul (CELAFISCS), São Paulo, Brazil.
| | - Mauro Fisberg
- Adolescent Medicine Sector (Adolescent Care and Support Center) of the Pediatrics Department of the Federal University of São Paulo, São Paulo, Brazil.
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Dulskiene V, Kuciene R, Medzioniene J, Benetis R. Association between obesity and high blood pressure among Lithuanian adolescents: a cross-sectional study. Ital J Pediatr 2014; 40:102. [PMID: 25492217 PMCID: PMC4265335 DOI: 10.1186/s13052-014-0102-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 12/04/2014] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Most epidemiological studies have shown that the prevalence of high blood pressure (BP) has significantly increased among children and adolescents in various countries of the world. The aim of this study was to examine the associations between overweight, obesity, abdominal obesity and prehypertension and hypertension among Lithuanian adolescents aged 12-15 years. METHODS The subjects with increased BP (≥90th percentile) were screened on two separate occasions. Data on the body mass index (BMI), waist circumference (WC), and BP were analysed in 7,457 adolescents aged 12-15 years. Adjusted odds ratios (aORs) with 95% confidence intervals (CI) for the associations were estimated using multivariate logistic regression models. RESULTS After two screenings, the study participants were categorised as prehypertensive (12.8%), hypertensive (22.2%), and normotensive (65%). The overall prevalence of overweight, obesity, and abdominal obesity (if WC was in the ≥75th percentile) were 12.1%, 2.4%, and 9%, respectively. After adjusting for age and sex, significant associations were found between overweight and obesity and high BP, namely, prehypertension (overweight: aOR = 2.62; 95% CI 2.13-3.23; obesity: aOR = 4.81; 95% CI 3.08-7.52) and hypertension (overweight: aOR = 3.56; 95% CI 3.02-4.19; obesity: aOR = 6.64; 95% CI 4.65-9.49). Prehypertension was found to be significantly associated with WC in the 75th- < 90th percentiles (aOR = 3.16; 95% CI 2.43-4.10) and WC in the ≥90th percentile (aOR = 4.08; 95% CI 2.35-7.10). For hypertension, significant associations were detected with WC in the 75th- < 90th percentiles (aOR = 3.92; 95% CI 3.18-4.82) and WC in the ≥90th percentile (aOR = 7.41; 95% CI 4.97-11.05). CONCLUSIONS Overweight, obesity, and abdominal obesity were associated with prehypertension and hypertension.
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Affiliation(s)
- Virginija Dulskiene
- Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukileliu ave. 17, LT-50009, Kaunas, Lithuania.
| | - Renata Kuciene
- Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukileliu ave. 17, LT-50009, Kaunas, Lithuania.
| | - Jurate Medzioniene
- Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukileliu ave. 17, LT-50009, Kaunas, Lithuania.
| | - Rimantas Benetis
- Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukileliu ave. 17, LT-50009, Kaunas, Lithuania.
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de Moraes ACF, Lacerda MB, Moreno LA, Horta BL, Carvalho HB. Prevalence of high blood pressure in 122,053 adolescents: a systematic review and meta-regression. Medicine (Baltimore) 2014; 93:e232. [PMID: 25501086 PMCID: PMC4602805 DOI: 10.1097/md.0000000000000232] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Several studies have reported high prevalence of risk factors for cardiovascular disease in adolescents. To perform: i) systematically review the literature on the prevalence of high blood pressure (HBP) in adolescents; ii) analyze the possible methodological factors associated with HBP; and iii) compare the prevalence between developed and developing countries. We revised 10 electronic databases up to August 11, 2013. Only original articles using international diagnosis of HBP were considered. The pooled prevalence's of HBP were estimated by random effects. Meta-regression analysis was used to identify the sources of heterogeneity across studies. Fifty-five studies met the inclusion criteria and total of 122,053 adolescents included. The pooled-prevalence of HBP was 11.2%, 13% for boys, and 9.6% for girls (P < 0.01). Method of measurement of BP and year in which the survey was conducted were associated with heterogeneity in the estimates of HBP among boys. The data indicate that HBP is higher among boys than girls, and that the method of measurement plays an important role in the overall heterogeneity of HBP value distributions, particularly in boys.
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Affiliation(s)
- Augusto César Ferreira de Moraes
- From the School of Medicine of the University of São Paulo (FMUSP)-Department of Preventive Medicine, São Paulo, Brazil (ACFdeM, MBL, HBC); YCARE (Youth/Child and cARdiovascular Risk and Environmental) Research Group, FMUSP/Brazil (ACFdeM, MBL, HBC); Faculty of Health of the University of Zaragoza, GENUD-Growth, Exercise, Nutrition and Development, Zaragoza, Spain (ACFdeM, LAM); Visiting Professor, School of Medicine of the University of São Paulo-Department of Preventive Medicine, São Paulo, Brazil (LAM); and School of Medicine of the Federal University of Pelotas, Pelotas, Brazil (BLH)
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Prehypertension and Hypertension among Schoolchildren in Brazzaville, Congo. Int J Hypertens 2014; 2014:803690. [PMID: 24963398 PMCID: PMC4054926 DOI: 10.1155/2014/803690] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2014] [Accepted: 05/06/2014] [Indexed: 11/18/2022] Open
Abstract
Background. To determine the prevalence and associated factors of prehypertension (pre-HT) and hypertension (HT) in schoolchildren at Brazzaville (Congo). Methods. This cross-sectional study was conducted from March to May 2011 in five representative urban schools in Brazzaville. American Pediatric Society's definition of pre-HT and HT was used. The measurement of blood pressure was obtained using auscultator method. Univariable and multivariable analyses were performed to establish associations between blood pressure levels and sociobiographical factors. Results. 603 children were included. The mean age was 11.8 ± 3.6 years (range 5-18 years). The prevalence of pre-HT was 20.7% (n = 125). Factors associated with pre-HT were secondary school (P = 0.02), private schools (P < 0.004), migrants (P = 0.03), the obese (P = 0.004), high socioeconomic level (P < 0.01), and overweight (P = 0.02). In logistic regression, the independent determinants of pre-HT were secondary school (P = 0.0001), migration (P = 0.04), obesity (P = 0.004), and overweight (P = 0.01). The prevalence of HT was 10.1% (n = 61) during the first screening and 3.3% (n = 20) in second screening. The independent determinants of HT were obesity (P = 0.0001) and overweight (P = 0.0001). Conclusion. Pre-HT and HT are emerging as a mass problem in Congolese schoolchildren with urban migration and overweight/obesity to be controlled and prevented.
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Kuciene R, Dulskiene V. Associations of short sleep duration with prehypertension and hypertension among Lithuanian children and adolescents: a cross-sectional study. BMC Public Health 2014; 14:255. [PMID: 24628980 PMCID: PMC3984754 DOI: 10.1186/1471-2458-14-255] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 03/12/2014] [Indexed: 01/19/2023] Open
Abstract
Background Recent epidemiological studies have found that the prevalence of high blood pressure (BP) has significantly increased among children and adolescents. The aim of this study was to examine the associations between short sleep duration and prehypertension and hypertension in Lithuanian children and adolescents aged 12 to 15 years. Methods A cross-sectional study was conducted from November 2010 to April 2012. The participants with high BP (≥90th percentile) were screened on two separate occasions. Self-reported sleep duration was evaluated using questionnaires. Data on 6,940 subjects aged 12–15 years were analyzed. Adjusted odds ratios (aORs) with 95% confidence intervals for the associations were estimated using multivariate logistic regression models. Short sleep duration was defined as <8 hours per day (h/day). Results The prevalence of prehypertension and hypertension in the current sample was 12.6% and 22.5%, respectively. The percentages of the subjects with sleep durations of <7 (h/day), 7– < 8 h/day, and ≥8 h/day were 8.7%, 21.0%, and 70.3%, respectively. After adjusting for age, sex, body mass index, physical activity, and smoking, significant associations were found between short sleep duration and high BP, including prehypertension (7– < 8 h/day: aOR = 1.77; 95% CI, 1.48–2.12; <7 h/day: aOR = 2.18; 95% CI, 1.70–2.79) and hypertension (7– < 8 h/day: aOR = 1.99; 95% CI, 1.72–2.31; <7 h/day: aOR = 2.28; 95% CI, 1.85–2.80) (all P values <0.001), compared to participants who were sleeping longer (≥8 h/day). Conclusions Prehypertension and hypertension were associated with short sleep duration among Lithuanian children and adolescents aged 12 to 15 years.
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Affiliation(s)
- Renata Kuciene
- Laboratory of Population Studies, Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukileliu 17, LT-50009 Kaunas, Lithuania.
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Odetunde OI, Neboh EE, Chinawa JM, Okafor HU, Odetunde OA, Ezenwosu OU, Ekwochi U. Elevated arterial blood pressure and body mass index among Nigerian preschool children population. BMC Pediatr 2014; 14:64. [PMID: 24593321 PMCID: PMC3973892 DOI: 10.1186/1471-2431-14-64] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 02/26/2014] [Indexed: 11/25/2022] Open
Abstract
Background Arterial blood pressure tends to rise with growth and development. Elevated blood pressure (EBP) in children usually occurs during the first two decades of life, and the children with hypertension tend to grow into adulthood with the high level of blood pressure. The prevalence of hypertension in children is increasing, the causes likely to be of different combination of factors. In this study we ascertained the prevalence of EBP in pre-school children in Enugu metropolis, South-East Nigeria and also determined its association with some factors like the Body Mass Index (BMI), urinalysis finding, family history, gender, age and socioeconomic class. Method A Stratified method of sampling was used to select subjects from registered nursery schools (Pre- elementary school) within Enugu metropolis. Physical examination of the recruited pupils was done with emphasis on arterial blood pressure, anthropometric measurements and urinalysis. Result Six hundred and thirty children (630) were studied out of which 345 (54.8%) were males and 285 (45.2%) were females. Sustained EBP (mainly systolic) were recorded in 12 pupils (1.9%) giving a prevalence of 1.9% of the pre-school population. The twelve (1.9%) pupils were all 5 years of age (p value = 0.001) and 11 (1.72%) of them were of under-weight BMI. The prevalence of obesity is 0.5% and that of under-weight is 92% of the studied population. There is no association between EBP and obesity (p value = 0.679). All the pupils with EBP had protein-free urine and no hematuria. Conclusions EBP and under-weight malnutrition is common in children in 5 years age group. EBP in preschool children is not influenced by their body mass index, urinalysis finding, gender, family history of hypertension or socioeconomic class.
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Affiliation(s)
- Odutola I Odetunde
- Pediatric Nephrology Unit, Department of Pediatrics, University of Nigeria Teaching Hospital, UNTH, PMB 01129 Ituku-Ozalla Enugu State, Nigeria.
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Guo X, Zheng L, Li Y, Zhang X, Yu S, Sun Y. Blood pressure to height ratio: A novel method for detecting hypertension in paediatric age groups. Paediatr Child Health 2014; 18:65-9. [PMID: 24421658 DOI: 10.1093/pch/18.2.65] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2012] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND A novel method for detecting hypertension in paediatric age groups has recently been formulated using ratios of systolic blood pressure to height (SBPHR) and diastolic blood pressure to height (DBPHR). AIM To validate this approach and assess its applicability to children. METHODS A cross-sectional study of 6837 children and adolescents five to 18 years of age was conducted. Blood pressure (BP) readings obtained were stratified using population-based percentiles from the United States. RESULTS For SBPHR and DBPHR, areas under the ROC curve were >0.9 for BP at or above the 95th percentile. Performance of the cut-off points for detecting elevated BP in adolescents 13 to 18 years of age compared favourably with previous studies, showing high sensitivity and specificity (>95%). SBPHR and DBPHR also proved satisfactory when applied to children five to 12 years of age. Nevertheless, performance was lower for BP between the 90th and 95th percentiles. CONCLUSIONS BP to height ratios are a practical means for detecting elevated BP in adolescents and children.
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Affiliation(s)
- Xiaofan Guo
- Department of Cardiology, the First Hospital of China Medical University; Shenyang, People's Republic of China
| | - Liqiang Zheng
- Department of Clinical Epidemiology, Library, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China
| | - Yang Li
- Department of Cardiology, the First Hospital of China Medical University; Shenyang, People's Republic of China
| | - Xingang Zhang
- Department of Cardiology, the First Hospital of China Medical University; Shenyang, People's Republic of China
| | - Shasha Yu
- Department of Cardiology, the First Hospital of China Medical University; Shenyang, People's Republic of China
| | - Yingxian Sun
- Department of Cardiology, the First Hospital of China Medical University; Shenyang, People's Republic of China
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Ujunwa FA, Ikefuna AN, Nwokocha ARC, Chinawa JM. Hypertension and prehypertension among adolescents in secondary schools in Enugu, South East Nigeria. Ital J Pediatr 2013; 39:70. [PMID: 24180427 PMCID: PMC4228429 DOI: 10.1186/1824-7288-39-70] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Accepted: 10/25/2013] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Hypertension is a prevalent cardiovascular disease risk factor among blacks and adolescent hypertension can progress into adulthood. OBJECTIVE To determine the prevalence of hypertension and prehypertension among secondary school adolescents in Enugu South East Nigeria. METHODOLOGY A study of 2694 adolescents aged 10-18 years in Enugu metropolis was carried out. Socio-demographic profile anthropometric and blood pressure readings were obtained. Derived measurements such as Prehypertension, hypertension and BMI were obtained. RESULTS The results showed that the mean systolic blood pressure and diastolic blood pressure for males were 106.66+ 11.80 mmHg and 70.25 + 7.34 mmHg respectively. The mean SBP and DBP for females were 109.83+ 11.66 mmHg and 72.23 + 8.26 mmHg respectively (p < 0.01). Blood pressure was found to increase with age. Prevalence of hypertension and prehypertension was 5.4% and 17.3% respectively with a higher rate in females (6.9%) than males (3.8%). Prevalence of prehypertension among males and females were 14.3% and 20.1% respectively. The prevalence of obesity was 1.9%. CONCLUSION Modifiable risk factors exist among adolescents. Early lifestyle modification and a strengthened school health are recommended.
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Affiliation(s)
- Fortune A Ujunwa
- Department of Paediatrics, University of Nigeria Teaching Hospital, Enugu 400001, Nigeria
| | - Anthony N Ikefuna
- Department of Paediatrics, University of Nigeria Teaching Hospital, Enugu 400001, Nigeria
| | - Ada RC Nwokocha
- Department of Paediatrics, University of Nigeria Teaching Hospital, Enugu 400001, Nigeria
| | - Josephat M Chinawa
- Department of Paediatrics, University of Nigeria Teaching Hospital, Enugu 400001, Nigeria
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Okoh BA, Alikor EA, Akani N. Prevalence of hypertension in primary school-children in Port Harcourt, Nigeria. Paediatr Int Child Health 2013; 32:208-12. [PMID: 23164295 DOI: 10.1179/2046905512y.0000000039] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND Hypertension is defined as average systolic and/or diastolic blood pressure (BP) ≥95th per centile for gender, age and height, and pre-hypertension as ≥90th and <95th per centile, measured on three occasions. Although the prevalence of hypertension during childhood is lower than that in adulthood, it is not rare in children. AIMS AND OBJECTIVES To evaluate the prevalence of hypertension and its severity in primary school-children in Port Harcourt. METHODS A stratified, multi-staged sampling technique was used to recruit pupils between 6 and 12 years of age in 13 primary schools. Data were collected using a pre-tested questionnaire completed by parents/guardians. The average of three blood pressure measurements was taken for each pupil using standardized techniques. RESULTS A total of 1302 pupils of whom 585 (44·9%) males and 717 (55·1%) females were studied, giving a male to female ratio of 1:1·2. The prevalence of hypertension was 61 (4·7%), 55 (4·2%) with stage 1 and six (0·5%) with stage 2 hypertension. Sixty (4·6%) of the pupils had pre-hypertension. Twenty-three (3·9%) of the 585 males and 38 (5·3%) of the 717 females were hypertensive (P = 0·25). The mean (SD) age of 8·83 (1·90) years for the normotensive children was higher than the mean (SD) age of 8·56 (2·05) years for the hypertensive children (P = 0·27). Of the study subjects, 152 (11·7%) were underweight, 998 (76·7%) were of normal weight, 75 (5·7%) were overweight and 77 (5·9%) were obese. The prevalence of hypertension among the different weight groups fell steadily from 13 (16·9%) in the obese children to 4 (5·3%) in the overweight children, to 43 (4·3%) in the normal weight children and one (0·7%) in the underweight children (P<0·001). CONCLUSION The prevalence of hypertension in school-children in Port Harcourt is 4·7% which is similar to that in other studies in Nigeria and elsewhere. A higher BMI was significantly associated with a higher prevalence of hypertension.
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Affiliation(s)
- Boma Alali Okoh
- Department of Paediatrics, University of Port Harcourt Teaching Hospital, Rivers State, Nigeria.
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Ejike CECC, Yin FZ. Blood pressure-to-height ratio simplifies the diagnosis of hypertension in Nigerian children. J Trop Pediatr 2013; 59:160-1. [PMID: 23230005 DOI: 10.1093/tropej/fms064] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The diagnostic accuracy of blood-pressure-to-height-ratios (BPHRs) in 716 Nigerian children was studied, using standard protocols. Systolic BPHR (SBPHR) and diastolic BPHR (DBPHR) had diagnostic accuracies ranging from 0.934 to 1.000, irrespective of sex and age. Optimal thresholds of SBPHR/DBPHR are provided, and their sensitivities and specificities all exceeded 80%. BPHR is a simple, sensitive and specific tool for the diagnosis of hypertension in this population.
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Guo X, Zheng L, Li Y, Yu S, Zhou X, Wang R, Zhang X, Sun Z, Sun Y. Gender-specific prevalence and associated risk factors of prehypertension among rural children and adolescents in Northeast China: a cross-sectional study. Eur J Pediatr 2013; 172:223-30. [PMID: 23108847 DOI: 10.1007/s00431-012-1873-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Accepted: 10/16/2012] [Indexed: 12/27/2022]
Abstract
UNLABELLED Little is known about the prevalence and risk profile of prehypertension among Chinese children and adolescents. The aim of the present study was to investigate the prehypertensive status and its associated risk factors among rural Chinese children and adolescents. We conducted a cross-sectional study including 5,245 children and adolescents (2,732 boys and 2,513 girls) aged 5-18 years in Northeast China. Main anthropometric data and related information were collected. The overall prevalence of prehypertension and hypertension was 15 % and 20.2 %, respectively. The prevalence of prehypertension among boys was 15.7 %, compared to that of 14.2 % among girls (P = 0.256). After adjusting for age, race, weight status, waist circumference, triceps skinfold, family income, smoking and drinking status, boys aged 12-14 and 15-18 years had a 2.86- and 5.97-fold risk of prehypertension, respectively, compared to those aged 5-8 years. Overweight and obese boys had an increased risk of prehypertension in comparison to those with normal weight (overweight: odds ratio [OR] = 1.837, 95 % confidence interval [CI] 1.321-2.556; obese: OR = 2.941, 95 % CI 1.783-4.851). A larger triceps skinfold (≥90th percentile) was significantly related to increased odds of prehypertension (OR = 2.32; 95 % CI, 1.516-3.55) among boys. For girls, only older age was found to be a risk factor for prehypertension. CONCLUSION Pediatric prehypertension is highly prevalent in rural Northeast China. The risk factors for prehypertension differed among boys and girls. A more comprehensive risk profile of prehypertension among children and adolescents needs to be established for early prevention.
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Affiliation(s)
- Xiaofan Guo
- Department of Cardiology, the First Hospital of China Medical University, 155 Nanjing North Street, Shenyang, Heping District, 110001, China
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Oduwole AA, Ladapo TA, Fajolu IB, Ekure EN, Adeniyi OF. Obesity and elevated blood pressure among adolescents in Lagos, Nigeria: a cross-sectional study. BMC Public Health 2012; 12:616. [PMID: 22867531 PMCID: PMC3490830 DOI: 10.1186/1471-2458-12-616] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2012] [Accepted: 07/18/2012] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Childhood obesity and associated hypertension are major public health concerns globally. This study aimed to determine the prevalence of obesity and the associated risk of high blood pressure among Nigerian adolescents. METHODS A cross-sectional school-based study of 885 apparently healthy adolescents was performed. Weight, height and blood pressure (BP) were measured using standard methods. Body mass index (BMI) was calculated and categorized by age, sex and percentile. Obesity and overweight were defined as: ≥ 95th and 85th to < 95th percentiles, respectively, for age, sex and height. Subjects were sub-categorized into age 10-13 years (A) and 14-17 years (B). The odds ratio for pre-hypertensive and hypertensive range BP by age and BMI were generated. Significance was set at P < 0.05. RESULTS The prevalence of overweight and obesity were 13.8% and 9.4%, respectively. The prevalence of hypertensive range systolic BP in obese versus normal BMI females was 16% versus 23% (p=0.00) and 12.1% versus 6.4% (p=0.27) in males. The prevalence of hypertensive range diastolic BP in obese versus normal BMI females was 12% versus 1.4% (p=0.00) and 15.2% versus 3.5% (p=0.01) in males. BMI in group B was significantly associated with pre-hypertensive and hypertensive range systolic BP in overweight (P = 0.01, P = 0.002) and obese subjects (P = 0.00, P = 0.00) and with hypertensive range diastolic BP (P = 0.00) only in obese subjects. The only significant association in group A was between obesity and pre-hypertensive range diastolic BP (P = 0.00). CONCLUSION The prevalence of hypertensive range BP among obese Nigerian adolescents was high. Screening for childhood obesity and hypertension, and long-term follow-up of obese adolescents into adulthood are recommended.
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Affiliation(s)
- Abiola A Oduwole
- Department of Paediatrics, College of Medicine, University of Lagos, Lagos, Nigeria
- Department of Paediatrics, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Taiwo A Ladapo
- Department of Paediatrics, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Iretiola B Fajolu
- Department of Paediatrics, College of Medicine, University of Lagos, Lagos, Nigeria
- Department of Paediatrics, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Ekanem N Ekure
- Department of Paediatrics, College of Medicine, University of Lagos, Lagos, Nigeria
- Department of Paediatrics, Lagos University Teaching Hospital, Lagos, Nigeria
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Al-Majed HT, Sadek AA. Pre-hypertension and hypertension in college students in Kuwait: a neglected issue. J Family Community Med 2012; 19:105-12. [PMID: 22870414 PMCID: PMC3410173 DOI: 10.4103/2230-8229.98296] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE To determine the proportion of pre-hypertension and hypertension in college students in Kuwait and their related risk factors. MATERIALS AND METHODS A total of 803, randomly selected students aged 17 to 23 years (346 male, 457 female) from different colleges in Kuwait, were included in the study between 2009 and 2010. Systolic and diastolic blood pressure measurements were taken by trained personnel. Pre-hypertension was defined as systolic pressure between 120 and 139 mm Hg or diastolic pressure between 80 and 89 mm Hg. Risk factor measurements that were determined, included smoking, body mass index (BMI), and family history of hypertension. Blood samples were collected and impaired glucose tolerance (IGT) and lipid profile levels were determined. RESULTS There were no hypotensive students. Normotensives constituted 53.5% (n = 430), pre-hypertensives formed 39.5% (n = 317), and hypertensive students comprised of 7% (n = 56). The overall proportions of hypertension and pre-hypertension were higher among male students (85.7 and 64.4%) than female students (14.3 and 35.6%), respectively. Hypertensive and pre-hypertensive students versus normotensive students had significantly higher levels of BMI-based obesity, smoking, glycated hemoglobin (HbA1c), and IGT. Also, hypertensive and pre-hypertensive, compared to normotensive students, had significantly higher proportions (21.4, 18.3, and 4.0%, respectively) of risky high-density lipoprotein (HDL) level (< 1 mg / dL), cholesterol (7.1, 3.8, and 1.4%, respectively), and triglycerides (TG) (17.9, 9.1, and 7.9%, respectively) where p was< 0.001, 0.016, and 0.051, respectively. CONCLUSION Hypertensive and pre-hypertensive students showed elevated levels of lipids and BMI-based obesity more than normotensive students. TG, HDL, HbA1c, and cholesterol appeared to influence pre-hypertension.
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Affiliation(s)
- Hana T Al-Majed
- Department of Applied Medical Sciences, College of Health Sciences, Public Authority of Applied Education and Training, Kuwait.
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Guo X, Zhang X, Li Y, Zhou X, Yang H, Ma H, Wang N, Liu J, Zheng L, Sun Y. Differences in healthy lifestyles between prehypertensive and normotensive children and adolescents in Northern China. Pediatr Cardiol 2012; 33:222-8. [PMID: 21915719 DOI: 10.1007/s00246-011-0112-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2011] [Accepted: 08/22/2011] [Indexed: 01/30/2023]
Abstract
BACKGROUND This study aimed to evaluate the prevalence and differences of healthy lifestyles among children and adolescents differing in blood pressure status. METHODS A cross-sectional study analyzed 5,270 children and adolescents ages 5-18 years. Anthropometric measurements and information on six healthy lifestyles (normal body mass index [BMI], appropriate physical activity, sufficient sleep, appropriate breakfast, no smoking, and no alcohol use) were collected by well-trained personnel. RESULTS The prevalence of healthy lifestyles was relatively low. Only 22.4% of the study participants had all six healthy lifestyle characteristics. The participants with prehypertension were less likely to have a normal BMI (odds ratio [OR] 0.362; 95% confidence interval [CI] 0.292-0.449) or to be nonsmokers (OR 0.793; 95% CI 0.64-0.982) than those with normal blood pressure. Overall, the prehypertensive participants had a lower likelihood of having four to six (especially all 6) of the healthy lifestyles (OR 0.688; 95% CI 0.561-0.844) than their normotensive counterparts. In addition, some socioeconomic factors, such as family income, had an impact on healthy life habits. CONCLUSION Among children and adolescents, poor prehypertensive status was associated with a low likelihood of healthy lifestyles. Evaluation of multiple healthy lifestyles as a whole should receive more attention for better prevention and control of high blood pressure.
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Affiliation(s)
- Xiaofan Guo
- Department of Cardiology, China Medical University, Shenyang, People's Republic of China
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Guo X, Zheng L, Li Y, Yu S, Liu S, Zhou X, Zhang X, Sun Z, Wang R, Sun Y. Association between sleep duration and hypertension among Chinese children and adolescents. Clin Cardiol 2011; 34:774-81. [PMID: 21997181 DOI: 10.1002/clc.20976] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Accepted: 08/17/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Short sleep duration was reported to be associated with an increased risk of hypertension among adults. The present study aimed to investigate this association in children and adolescents. HYPOTHESIS Short sleep duration is related to higher risk of hypertension among children and adolescents. METHODS We conducted a cross-sectional study of 4902 children and adolescents age 5 to 18 years. Blood pressure (BP) was measured at the research center and classified using the population-based percentiles. Sleep duration and related information were determined through questionnaires. RESULTS The prevalence of hypertension and prehypertension were 20.3% and 15%, respectively. The median sleep duration was 8.77 ± 1.07 hours (mean ± standard deviation). A short sleep duration (<9 hours) was associated with a higher risk of hypertension when compared with the group sleeping longer (9-10 h), among boys age 11 to 14 years old (OR, 1.5; 95% CI, 1.04-2.15), adjusting for age, body mass index, waist circumference, and physical activity. The linear regression stratified by age indicated that for boys age 11 to 14 years the inverse association existed after adjustment with the coefficients -1.04 mm Hg and -0.55 mm Hg per hour of sleep for systolic BP and diastolic BP, respectively. CONCLUSIONS Short sleep duration (<9 h) is independently associated with hypertension among Chinese boys age 11 to 14 years old.
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Affiliation(s)
- Xiaofan Guo
- Department of Cardiology, First Affiliated Hospital, China Medical University, Shenyang, People's Republic of China
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Ejike CECC. Blood pressure to height ratios as simple, sensitive and specific diagnostic tools for adolescent (pre)hypertension in Nigeria. Ital J Pediatr 2011; 37:30. [PMID: 21702902 PMCID: PMC3131244 DOI: 10.1186/1824-7288-37-30] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2011] [Accepted: 06/24/2011] [Indexed: 11/18/2022] Open
Abstract
Background The age-, gender-, and height-percentile requirements of the 'gold-standard' for the diagnosis of (pre)hypertension in adolescents make it time-consuming for clinicians and difficult-to-use by non-professionals. Simplified diagnostic tools are therefore needed. The use of blood pressure-to-height ratio (BPHR) - systolic BPHR (SBPHR) and diastolic BPHR (DBPHR) - has been reported in Han adolescents, but it requires validation in other racial groups. The diagnostic accuracy of SBPHR and DBPHR in a population of 1,173 Nigerian adolescents aged 11-17 years, was therefore studied. Methods Blood pressures were measured using standard procedures and (pre)hypertension were defined according to international recommendations. ROC curve analyses were used to assess the diagnostic accuracy of BPHR in defining (pre)hypertension in this population. Sex-specific threshold values for SBPHR and DBPHR were determined, and thereafter used to define (pre)hypertension. The sensitivity/specificity of this method was determined. Results The accuracies of SBPHR and DBPHR in diagnosing (pre)hypertension, in both sexes, was >92%. The optimal thresholds for diagnosing prehypertension were 0.72/0.46 in boys and 0.73/0.48 in girls; while for hypertension, they were 0.75/0.51 in boys and 0.77/0.50 in girls. The sensitivity and specificity of this method were >96%. Conclusions The use of BPHR is valid, simple and accurate in this population. Race-specific thresholds are however needed.
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Affiliation(s)
- Chukwunonso E C C Ejike
- Department of Biochemistry, Michael Okpara University of Agriculture, PMB 7267 Umuahia, Abia State, Nigeria.
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