Assessing secular trends in blood pressure in children and adolescents

Bovet, Pascal; Paradis, Gilles

doi:10.1038/jhh.2008.165

Cited by 6 publications

(9 citation statements)

References 16 publications

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“…Research demonstrates that the prevalence of hypertension has increased over the last decade as a result of the increase in overweight and obesity amongst children. 6 Monyeki et al, 10 who focused on a relatively small group of black children (n=203) from disadvantaged communities, reported a 3.9% prevalence of hypertension in 6 -7-year-old children. However, none of the 6 -7-year-old children fell into the overweight category, which could also possibly contribute to the lower prevalence of hypertension that was reported in the study.…”

Section: Discussionmentioning

confidence: 99%

“…BP during childhood is significantly associated with BP during adulthood. 6 Therefore it is important to develop intervention programmes, especially those that are aimed at increasing levels of physical activity that would lead to weight loss in overweight and obese children and thus reduce the risk of hypertension. It is also advised that BP must be monitored from early childhood and that BP readings must be incorporated in the clinical evaluation of children on a routine basis so that possible cardiovascular risk factors can thus be monitored, especially in the case of overweight and obese children.…”

Section: Discussionmentioning

confidence: 99%

“…4 Until recently, hypertension was a rare phenomenon amongst children, possibly due to fewer environmental stressors, higher physical activity levels, a lower prevalence of obesity and a healthier lifestyle. 5 Chiolero et al 6 are of the opinion that the worldwide increase in obesity amongst children over the last two decades probably resulted in an increase in the incidence of hypertension in children. 6 In this respect, Munter et al 7 found that the systolic and diastolic BP of children were respectively 1.4 mmHg and 3.3 mmHg higher in 1999 -2000 than in 1988 -1994 and attribute this increase in hypertension largely to the increased incidence of overweight children.…”

Section: Introductionmentioning

confidence: 99%

“…5 Chiolero et al 6 are of the opinion that the worldwide increase in obesity amongst children over the last two decades probably resulted in an increase in the incidence of hypertension in children. 6 In this respect, Munter et al 7 found that the systolic and diastolic BP of children were respectively 1.4 mmHg and 3.3 mmHg higher in 1999 -2000 than in 1988 -1994 and attribute this increase in hypertension largely to the increased incidence of overweight children. Whitney and Rolfes 8 report that obesity contributes to the development of hypertension because additional adipose tissue contains extra capillaries through which the blood has to pump and, consequently, puts extra strain on the heart and veins, which results in increased BP.…”

Section: Introductionmentioning

confidence: 99%

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The prevalence of hypertension and the relationship with body composition in Grade 1 learners in the North West Province of South Africa

Kemp

Pienaar

Schutte

2011

S. Afr. j. sports med.

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Abstractobjective. To determine the prevalence of hypertension in Grade 1 learners in the North West Province of South Africa and to investigate the association between blood pressure (BP) and body composition of these children. Methods. Data were collected by means of a stratified random sampling procedure from 816 Grade 1 learners (419 boys, 397 girls) with a mean age of 6.78±0.49 years (mean±SD), in the NW-CHILD-study. Height, weight, skinfolds (subscapular, triceps, calf) and waist circumference were measured. The international recommended cut-off values of Cole et al. (2000) for body mass index (BMI) were used. Hypertension, defined as the average of two separate BP (BP) readings, where the systolic BP and diastolic BP is >95th percentile for age, sex and height, was determined by means of an Omron 705CP-II. Results. The overall prevalence of prehypertension and hypertension was 8.5% and 24.9%, respectively. Both systolic and diastolic BP was positively associated with BMI, body fat percentage and waist circumference. Boys and girls showed a similar prevalence of hypertension. A higher percentage of black children were hypertensive compared with whites, although the difference in BP of the groups was not significant. A high percentage of children with normal weight also showed increased levels of BP. Conclusions. High prevalences of hypertension were found in Grade 1 learners in the North West Province of South Africa. Small practical significant associations existed between BP and body composition. BP screening is therefore considered important in the paediatric population. Interventions which include physical activity are recommended to reduce potential cardiovascular complications and obesity among children. Other contributing factors to high BP amongst young children should also be investigated.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The prevalence of hypertension and the relationship with body composition in Grade 1 learners in the North West Province of South Africa

Kemp

Pienaar

Schutte

2011

S. Afr. j. sports med.

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“…Few studies have assessed the simultaneous secular trends of BMI and BP in children and adolescents [6]. The population-based studies of BP trends, performed in developed and developing countries, have not consistently shown that BP increases in parallel with obesity.…”

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confidence: 98%

Uncertainty in the assessment of trends in childhood blood pressure

Lurbe

2012

Journal of Hypertension

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H igh blood pressure (BP) is a clearly established, but modifiable, risk factor for early disability and death [1]. Although most of the adverse outcomes occur in adulthood it has become clear that hypertension (HTN) is a life course problem that can become evident in childhood and can be progressive throughout childhood into adolescence and adulthood. Although few would dispute the importance of taking effective steps to identify and manage this condition in middle-aged and elderly people, relatively little attention has been paid to the problem of high BP in children and adolescents.The incorporation of BP measurement into routine pediatric healthcare and the publication of norms for BP in children [2,3] has not only enabled detection of significant asymptomatic hypertension secondary to a previously undetected disorder, but it has also confirmed that mild elevations in BP during childhood are more common than previously recognized, particularly in adolescents. It has also become clear that children with elevated BP have an increased risk of left ventricular hypertrophy and increased carotid intima-media thickness as well as an increased risk of hypertension in adulthood [2,3].These findings support the potential for primordial prevention, that is, the prevention of elevated BP during childhood and adolescence. Prevention and management of hypertension, obesity, and other cardiovascular risk factors, such as dyslipidemia and insulin resistance, are critical for ensuring the health of young people today and the adults of tomorrow.Epidemiological approaches to studying risk factors for cardiovascular disease have proven to be quite helpful in better understanding disease processes and in generating important hypotheses for future studies. Examining secular trends in childhood BP could help us better understand population-level determinants of HTN. Secular trends are the changes in risk factor level and prevalence that occur in a population over time. These temporal trends can be instructive, because they occur in a time frame where it is unlikely that the genetic background has changed, indicating that they are most likely due to changes in environmental factors [4].Trends in childhood BP have been the object of only few studies but are of particular interest in the light of substantial increase in child obesity, the most important environmental factor for high BP in this age group. Because of the association between obesity and BP, it may be expected that levels of SBP and DBP among children would have also changed over the last several decades in parallel to changes in BMI. This parallel association was not found in some of the studies, and in those wherein an association was observed; it did not explain all the BP changes.In the current issue of the Journal of Hypertension, Peters et al. [5], provide the results of an analysis of secular trends in the level of childhood BP and the impact of obesity in the United Kingdom. On the basis of the data from over 25 000 children, a large increment was found in SBP and...

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