Discordant Secular Trends in Elevated Blood Pressure and Obesity in Children and Adolescents in a Rapidly Developing Country

Abstract

Background-The effect of the increasing prevalence of obesity on blood pressure (BP) secular trends is unclear. We analyzed BP and body mass index secular trends between 1998 and 2006 in children and adolescents of the Seychelles, a rapidly developing island state in the African region. Methods and Results-School-based surveys were conducted annually between 1998 and 2006 among all students in 4 school grades (kindergarten and 4th, 7th, and 10th years of compulsory school). We used the Centers for Disease Control and Prevention criteria to define obesity and elevated BP. The same methods and instruments were used in all surveys. Some 25 586 children and adolescents 4 to 18 years of age contributed 43 867 observations. Although the prevalence of obesity in boys and girls increased from 5.1% and 6.0%, respectively, in 1998 to 2000 to 8.0% and 8.7% in 2004 to 2006, the prevalence of elevated BP decreased from 8.4% and 9.8% to 6.9% and 7.8%. During the interval, mean age-adjusted body mass index increased by 0.57 kg/m 2 in boys and 0.58 kg/m 2 in girls. Mean age-and height-adjusted systolic BP decreased by Ϫ3.0 mm Hg in boys and Ϫ2.8 mm Hg in girls, whereas mean diastolic BP did not change substantially in boys (Ϫ0.2 mm Hg) and increased slightly in girls (0.4 mm Hg). Conclusion-At a population level, the marked increase in the prevalence of obesity in children and adolescents in the Seychelles was not associated with a commensurate secular rise in mean BP. (Circulation. 2009;119:558-565.)

The trend of hypertension and its relationship to the weight status among Taiwanese young adolescents

“…[24][25][26][27] In the United States, the Bogalusa heart study and the Minneapolis Children's BP Study illustrated a decline in either the SBP or DBP among different groups between the ages of 10 and 17 years, from 1981 to 1992 and 1986 to 1996, respectively. 24,25 In the Seychelles, the mean SBP declined 2.8-3.0 mm Hg in children, whereas the mean DBP did not change in boys, and elevated slightly (0.4 mm Hg) in girls between 1998 and 2006 (Chiolero et al 26 ).…”

Relationship between a range of sedentary behaviours and blood pressure during early adolescence

“…2,3 Thus, the recognition and management of elevated BP at an early age may be an important strategy for limiting the overall disease burden caused by hypertension. 4,5 Factors such as genetics, 6 diet 7 and physical activity 8 appear to contribute to elevated BP in children. In addition, population-based studies have consistently shown that overweight/obese children have higher levels of BP and a higher prevalence of hypertension than their non-overweight/obese counterparts.…”

Association between physical activity and blood pressure in prepubertal children

“…2,3 Thus, the recognition and management of elevated BP at an early age, and the identification of modifiable risk factors, may be an important strategy for limiting the overall public health disease burden caused by hypertension. 4,5 Physical activity is a key component of the therapeutic lifestyle changes recommended for preventing and treating elevated BP and hypertension in children and adolescence. 6,7 There is evidence that levels of physical activity, aerobic fitness and CVD risk factors track from childhood and adolescence into adulthood.…”