Abstract:Background: Hypertension has gained global significance and risk of cardiovascular disease, and adiposity is the most important of the conditions associated with and considered responsible for hypertension in children. Therefore, the present study aimed to determine whether indices of adiposity independently predicted blood pressure at multiple points in gender-specific groups. Methods: This was a cross-sectional study involving 10 randomly selected primary schools within the Ellisras Longitudinal Study, and i… Show more
“…Our result showed adolescent with an increase of one BMI kg/m 2 was 1.12 times at risk of developing hypertension, that is, increase in one BMI kg/m 2 contributed by 12% of developing blood pressure among adolescents. Similar to our study, other studies have shown a positive association between adolescent hypertension and increasing BMI 10 14 24 28 29. In South Africa, a study included 1665 schoolchildren and adolescents (846 boys and 819 girls) aged 5 to 15 years showed an increase of one BMI kg/m 2 was associated with 1.198 times and 1.23 times risk of developing systolic and diastolic hypertension, respectively 24…”
ObjectivesThere is an increasing rate of elevated blood pressure, or hypertension, in children and adolescents worldwide, including Sub-Saharan Africa (SSA). Only a few data on adolescent hypertension in SSA, including Sudan, have been published. The aim of the present study was to investigate the prevalence and associated factors of hypertension among adolescent schoolchildren (within the ages of 10 to 19 years) in Sudan.DesignA cross-sectional school-based study was conducted from June to September 2022.SettingsSix randomly selected schools in Almatamah, River Nile State, Sudan.ParticipantsAdolescent schoolchildren (within the ages of 10 to 19 years).Main outcome measuresSociodemographic information. Anthropometric and blood pressure measurements were performed in accordance with the standard procedures. An adjusted logistic regression analysis was performed.ResultsOf the 384 enrolled adolescents, 166 (43.2%) and 218 (56.8%) were boys and girls, respectively. The median (IQR) age and body mass index (BMI) were 15.2 years (14.0‒16.4 years) and 18.5 kg/m2(16.4‒21.5 kg/m2), respectively. Of the 384 adolescents, 240 (62.5%) and 255 (66.4%) had educated mothers and fathers (≥secondary), respectively. 38 adolescents (9.9%) had hypertension (≥95th percentile). The multivariable logistic regression analysis revealed that age, sex and maternal educational level were not associated with hypertension. Paternal educational level according to secondary education attainment (adjusted OR (AOR), 2.72; 95% CI 1.36‒5.46) and increasing BMI (AOR, 1.12; 95% CI 1.02‒1.20) were associated with hypertension.Conclusion1 in 10 adolescents in northern Sudan was hypertensive. Low paternal educational level and increasing BMI were significantly associated with hypertension. The introduction of interventional nutritional programmes at early ages is needed to ensure that adolescents are healthy in their present and later lives. To sustain such programmes, involving all educational parties at early stage is essential.
“…Our result showed adolescent with an increase of one BMI kg/m 2 was 1.12 times at risk of developing hypertension, that is, increase in one BMI kg/m 2 contributed by 12% of developing blood pressure among adolescents. Similar to our study, other studies have shown a positive association between adolescent hypertension and increasing BMI 10 14 24 28 29. In South Africa, a study included 1665 schoolchildren and adolescents (846 boys and 819 girls) aged 5 to 15 years showed an increase of one BMI kg/m 2 was associated with 1.198 times and 1.23 times risk of developing systolic and diastolic hypertension, respectively 24…”
ObjectivesThere is an increasing rate of elevated blood pressure, or hypertension, in children and adolescents worldwide, including Sub-Saharan Africa (SSA). Only a few data on adolescent hypertension in SSA, including Sudan, have been published. The aim of the present study was to investigate the prevalence and associated factors of hypertension among adolescent schoolchildren (within the ages of 10 to 19 years) in Sudan.DesignA cross-sectional school-based study was conducted from June to September 2022.SettingsSix randomly selected schools in Almatamah, River Nile State, Sudan.ParticipantsAdolescent schoolchildren (within the ages of 10 to 19 years).Main outcome measuresSociodemographic information. Anthropometric and blood pressure measurements were performed in accordance with the standard procedures. An adjusted logistic regression analysis was performed.ResultsOf the 384 enrolled adolescents, 166 (43.2%) and 218 (56.8%) were boys and girls, respectively. The median (IQR) age and body mass index (BMI) were 15.2 years (14.0‒16.4 years) and 18.5 kg/m2(16.4‒21.5 kg/m2), respectively. Of the 384 adolescents, 240 (62.5%) and 255 (66.4%) had educated mothers and fathers (≥secondary), respectively. 38 adolescents (9.9%) had hypertension (≥95th percentile). The multivariable logistic regression analysis revealed that age, sex and maternal educational level were not associated with hypertension. Paternal educational level according to secondary education attainment (adjusted OR (AOR), 2.72; 95% CI 1.36‒5.46) and increasing BMI (AOR, 1.12; 95% CI 1.02‒1.20) were associated with hypertension.Conclusion1 in 10 adolescents in northern Sudan was hypertensive. Low paternal educational level and increasing BMI were significantly associated with hypertension. The introduction of interventional nutritional programmes at early ages is needed to ensure that adolescents are healthy in their present and later lives. To sustain such programmes, involving all educational parties at early stage is essential.
“…Of 60 articles identified from the title and abstract screening, 53 presented data on hypertension prevalence specifically for African children between 1-19 years age range. Reasons for the exclusion of the remaining 7 articles were: Blood pressure (BP) was self-reported and not measured (n=1) (Letamo et al) [26] , the study sample spanned outside the desirable age range in which no age specific data could be extracted (n=2) (Bhimma et al [27] , Mokgwathi et al [28] ), the study was not conducted within an African population residing in Africa (n=2) (South et al [29] , South et al [30] ) and no extractable information regarding hypertension could be extracted from the results (n=2) (Muyumba et al [31] , Mphekgwana et al [32] ) ( Figure 1 ). Figure 1 Flow diagram of the study selection.…”
Background
The burden of cardiovascular disease (CVD) and hypertension is rapidly increasing in low- and middle-income countries. This is evident not only in adults, but also in children. Recent estimates of prevalence in children are lacking, particularly in Africa. As such, we conducted a systematic review and meta-analysis to provide updated estimates of paediatric hypertension in Africa.
Methods
We searched PubMed and EBSCO to identify articles published from January 2017 to November 2020. Studies were assessed for quality. We combined results for meta-analyses using a random effects model (Freeman-Tukey arcsine transformation). Heterogeneity was quantified using the I
2
statistic.
Findings
In the narrative synthesis of 53 studies, publication bias was low for 28, moderate for 24, and high for one study. Hypertension prevalence ranged substantially (0·2%-38·9%). Meta-analysis included 41 studies resulting in data on 52918 participants aged 3 to 19 years from ten countries. The pooled prevalence for hypertension (systolic/diastolic BP≥95th percentile) was 7·45% (95%CI 5·30-9·92, I
2
=98.96%), elevated blood pressure (BP, systolic/diastolic BP≥90th percentile and <95th percentile) 11·38% (95%CI 7·94-15·33, I
2
=98.97%) and combined hypertension/elevated BP 21·74% (95%CI 15·5-28·69, I
2
=99.48%). Participants categorized as overweight/with obesity had a higher prevalence of hypertension (18·5% [95%CI 10·2-28·5]) than those categorized as underweight/normal (1·0% [95%CI 0·1-2·6], 4·8% [95%CI 2·9-7·1], p<0·001). There were significant differences in hypertension prevalence when comparing BP measurement methods and classification guidelines.
Interpretation
Compared to a previous systematic review conducted in 2017, this study suggests a continued increase in prevalence of paediatric hypertension in Africa, and highlights the potential role of increasing overweight/obesity.
Funding
This research was funded in part by the Wellcome Trust [Grant number:214082/Z/18/Z]. LJW and SAN are supported by the DSI-NRF Centre of Human Development at the University of the Witwatersrand.
“…Of 60 articles identified from the title and abstract screening, 53 presented data on hypertension prevalence specifically for African children between 1-19 years age range. Reasons for the exclusion of the remaining 7 articles were: Blood pressure (BP) was selfreported and not measured (n=1) (Letamo et al) [26], the study sample spanned outside the desirable age range in which no age specific data could be extracted (n=2) (Bhimma et al [27], Mokgwathi et al [28]), the study was not conducted within an African population residing in Africa (n=2) (South et al [29], South et al [30]) and no extractable information regarding hypertension could be extracted from the results (n=2) (Muyumba et al [31], Mphekgwana et al [32]) (Figure 1).…”
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