Blood pressure and its associated factors among primary school children in suburban Selangor, Malaysia: A cross-sectional survey

Abstract

Background:Little is known about the relationship of blood pressure (BP) with adiposity indicators, dietary habits, physical activity, and sleep in school children in Malaysia. We aimed to study about the distribution of BP and its associated factors in primary school children.Materials and Methods:A survey was carried out on a random sample of 335 children in five primary schools. BP was measured with a mercury sphygmomanometer. Anthropometry was done by standard methods. Demographic information, dietary habits, physical activity, and duration of sleep were collected by interviews. World Health Organization classification based on body mass index (BMI) and waist circumference (WC) cut-offs were used to define overweight/obesity. Elevated BP was defined according to US reference standards.Results:A total 335 children (144 boys and 191 girls) were examined. Their mean age was 9.18 years (standard deviation [SD] = 0.28). Overall mean systolic blood pressure (SBP) and mean diastolic blood pressure (DBP) were 99.32 mmHg (SD = 10.79) and 67.11 mmHg (SD = 10.76), respectively. Mean BMI and WC were 16.39 (SD = 3.58) and 57.77 cm (SD = 8.98), respectively. The prevalence of pre-hypertension was 12.23% (95% confidence intervals [CIs] 8.73, 15.75) and hypertension was 13.4% (95% CIs 9.78, 17.09). Mean SBP and DBP was higher among overweight and obese children than normal children. By multivariate linear regression analyses, BMI (β = 0.250, P = 0.049) and WC (β = 0.308, P = 0.015) were positively associated with SBP; age (β = 0.111, P = 0.017), BMI (β = 0.320, P = 0.012) were positively associated with DBP but total (weekly) hours of sleep (β = −0.095, P = 0.037) was negatively associated with DBP.Conclusion:BP was associated with BMI and WC. Health promotion activities should be initiated in primary schools.

Obesity-associated Hypertension among Primary School Children in Sarawak: A Cross-sectional Study

“…the prevalence of prehypertension and hypertension in this study, it was found to be 13.5% and 8.1%, respectively, lower than other local studies (pre-hypertension 12.23%, hypertension 13-14%) (Screeamareddy et al 2013;, the prevalence of overweight and obesity (36.9%), overfat and obese (31.0%), abnormal waist circumference (29.0%) and waist-toheight ratio (32.8%) was high among the respondents. Literature reported that obesity itself can be the main factor that is strongly associated with hypertension, carried a relative risk of 14.7 for systolic hypertension after adjustment for family history (Salman et al 2011).…”

“…A recent school survey carried out locally indicated that 12.23% of the children were prehypertensive and 13.4% hypertensive. The mean systolic blood pressure and diastolic blood pressure were higher among those children who were overweight and obese (Screeamareddy et al 2013).…”

“…Sample size was calculated using PS power and sample size calculation software. Based on the prevalence of childhood hypertension and pre hypertension in a local study (Screeamareddy et al 2013) 25.6%, using 2 proportion sample size calculation, considering the prevalence of not more than 10% increase than that of 2013, the minimum sample size needed was 675. The expectant dropout rate was 30% with 1.5 design effect, therefore, the needed sample size for this study was 1316 samples.…”

“…As far as our concern, the study on hypertension among primary school in Malaysia is limited with one study carried out in Peninsular Malaysia (Screeamareddy et al 2013) and another one in Sabah, East Malaysia (Chong et al 2011). However, these studies did not relate obesity related indicators in the determination of hypertension at risk.…”

Association of Parental E ducation and Illness with Obesity and Blood Pressure in 13-16 Year Old Girls

“…Screening of school children for BP has identified obesity and family history of diabetes mellitus, ischemic heart disease and hypertension as significant risk factors 11,13,15 . Amongst the adiposity indicators body mass index (BMI) and waist circumference seems (WC) to be positively associated with increasing BP [16][17][18] . The risk for elevated BP in children is three times greater in obese children compared to non-obese children 19 .…”