Selective Blood Pressure Screening in the Young: Quantification of Population Wide Underestimation of Elevated Blood Pressure

Universal blood pressure (BP) screening in children and adolescents is questioned in prevention guidelines, while measuring blood pressure in the young in the context of overweight, obesity, or parental hypertension is promoted. This study quantifies with population data the underestimation of elevated blood pressure that would result from limiting BP screening only to those with overweight, obesity, or parental hypertension in the young. Selective screening was simulated with representative national health examination data from Germany (age 3-17, N=14,633, KiGGS0 study 2003-2006; age 18-39, N=1,884, DEGS1 2008-2011 study), with mean of two oscillometric measurements on one occasion; cutoffs for hypertensive BP in children were the 95th percentile using KiGGS percentiles, and for sensitivity analyses Fourth Report percentiles, in adults 140/90 mmHg; childhood overweight and obesity were classified according to the International Obesity Task Force and for adults as BMI ≥25 and ≥30 kg/m2. In 3-17-year-olds, different selective BP screening scenarios were simulated: screening only in those with obesity, overweight, parental hypertension, combination of overweight and parental hypertension, resulting in screening 5.6%, 20.0%, 28.5%, and 42.6% of the population and detecting 17.2%, 38.6%, 30.3%, and 58.2% of all hypertensive cases in the population. In conclusion our results show a large screening gap that would result from selective BP screening only in those with overweight, obesity, or parental hypertension.

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BLOOD PRESSURE IN CHILDREN ACCORDING TO THE INTERNATIONAL OBESITY TASK FORCE DEFINITIONS OF CHILDHOOD OVERWEIGHT AND OBESITY

Journal of Hypertension ◽

10.1097/00004872-200406002-00284 ◽

2004 ◽

Vol 22 (Suppl. 2) ◽

pp. S83

Author(s):

G. Barba ◽

E. Troiano ◽

A. Venezia ◽

P. Russo ◽

L. Bruno ◽

...

Keyword(s):

Blood Pressure ◽

Task Force ◽

Childhood Overweight ◽

Overweight And Obesity ◽

International Obesity Task Force ◽

Childhood Overweight And Obesity

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Inequalities in cardiovascular risks among Swedish adolescents (ABIS): a prospective cohort study

BMJ Open ◽

10.1136/bmjopen-2019-030613 ◽

2020 ◽

Vol 10 (2) ◽

pp. e030613

Author(s):

Pär Andersson White ◽

Johnny Ludvigsson ◽

Michael P Jones ◽

Tomas Faresjo

Keyword(s):

Blood Pressure ◽

Cardiovascular Risk ◽

Roc Curve ◽

Overweight And Obesity ◽

Elevated Blood Pressure ◽

High Density Lipoproteins ◽

Elevated Blood ◽

Cardiovascular Risks ◽

Increased Risk ◽

Low Hdl

ObjectivesTo investigate if socioeconomic status (SES) is predictive of cardiovascular risk factors among Swedish adolescents. Identify the most important SES variable for the development of each cardiovascular risk factor. Investigate at what age SES inequality in overweight and obesity occurs.DesignLongitudinal follow-up of a prospective birth cohort.SettingAll Babies in Southeast Sweden (ABIS) study includes data from children born between October 1997 and October 1999 in five counties of south east Sweden.ParticipantsA regional ABIS-study subsample from three major cities of the region n=298 adolescents aged 16–18 years, and prospective data from the whole ABIS cohort for overweight and obesity status at the ages 2, 5, 8 and 12 years (n=2998–7925).Outcome measuresBlood pressure above the hypertension limit, overweight/obesity according to the International Obesity Task Force definition, low high-density lipoproteins (HDL) or borderline-high low-density lipoproteins according to National Cholesterol Education Program expert panel on cholesterol levels in children.ResultsFor three out of four cardiovascular risk outcomes (elevated blood pressure, low HDL and overweight/obesity), there were increased risk in one or more of the low SES groups (p<0.05). The best predictor was parental occupational class (Swedish socioeconomic classification index) for elevated blood pressure (area under the receiver operating characteristic (ROC) curve 0.623), maternal educational level for overweight (area under the ROC curve 0.641) and blue-collar city of residence for low HDL (area under the ROC curve 0.641). SES-related differences in overweight/obesity were found at age 2, 5 and 12 and for obesity at age 2, 5, 8 and 12 years (all p<0.05).ConclusionsEven in a welfare state like Sweden, SES inequalities in cardiovascular risks are evident already in childhood and adolescence. Intervention programmes to reduce cardiovascular risk based on social inequality should start early in life.

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Elevated blood pressure and its relationship with bodyweight and anthropometric measurements among 8–11-year-old Indonesian school children

Journal of Public Health Research ◽

10.4081/jphr.2020.1723 ◽

2020 ◽

Vol 9 (1) ◽

Author(s):

Nawanto Agung Prastowo ◽

Ignatio Rika Haryono

Keyword(s):

Blood Pressure ◽

School Children ◽

Pearson Correlation ◽

Cross Sectional Study ◽

Overweight And Obesity ◽

Elevated Blood Pressure ◽

Elevated Blood ◽

Chi Square ◽

Anthropometric Measures ◽

Cross Sectional

Objective: Increased prevalence of elevated blood pressure in children and adolescents was associated with increased body weight and measures. Also, prevalence of elevated blood pressure varies between countries. This study is to investigate the prevalence of elevated blood pressure in Indonesian children and its relationship with bodyweight and anthropometric measures.Methods: This cross-sectional study involved 1010 elementary students aged 8–12 years (479 girls, 531 boys). The anthropometric measures and blood pressure were assessed. Elevated blood pressure (EBP) was determined if at the 90th percentile or above for gender, age, and height. Independent t-test, Chi-square, Pearson correlation, and multivariate logistic regression were applied. Significance was determined at p<0.05.Results: Overall prevalence of EBP was 28.8% (35.9% in girls, 22.4% in boys). BMI, waist circumference (WC), waist to height ratio (WHtR), and abdominal skinfold had significant correlation with EBP. Elevated BP was higher in overweight and obesity than in normoweight (60.5% vs 39.5%, p=0.00). In girls, the OR of EBP for overweight and obesity were 2.33 (95% CI 1.40 - 3.87, p=0.03) and 3.44 (95% CI 1.98 - 5.99, p=0.00) whereas in boys were 4.26 (95% CI 2.20 - 8.28, p=0.00) and 8.82 (95% CI 5.10 - 15.38, p=0.00).Conclusions: Prevalence of EBP in Indonesian school children aged 8-11 years was higher and more prevalent in overweight/obesity and in girls. Anthropometric measures were correlated with EBP.

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Elevated Blood Pressure in Relation to Overweight and Obesity Among Children in a Rural Canadian Community

PEDIATRICS ◽

10.1542/peds.2008-0951 ◽

2008 ◽

Vol 122 (4) ◽

pp. e821-e827 ◽

Cited By ~ 82

Author(s):

Marina Salvadori ◽

Jessica M. Sontrop ◽

Amit X. Garg ◽

Jennifer Truong ◽

Rita S. Suri ◽

...

Keyword(s):

Blood Pressure ◽

Overweight And Obesity ◽

Elevated Blood Pressure ◽

Elevated Blood

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Obesity Epidemic in Urban Tanzania: A Public Health Calamity in an already Overwhelmed and Fragmented Health System.

10.21203/rs.2.19235/v1 ◽

2019 ◽

Cited By ~ 1

Author(s):

Pedro Pallangyo ◽

Lucy Mgopa ◽

Zabella S. Mkojera ◽

Naairah R. Hemed ◽

Happiness J. Swai ◽

...

Keyword(s):

Public Health ◽

Blood Pressure ◽

Fast Food ◽

Associated Factors ◽

Dar Es Salaam ◽

Overweight And Obesity ◽

Sub Saharan Africa ◽

Elevated Blood Pressure ◽

Smoking History ◽

Elevated Blood

Abstract Background Worldwide, the epidemiological and demographic transitions have resulted in nutrition shift characterized by an increased consumption of sugar-sweetened beverages and energy-dense fast food products. In just over 3 decades, overweight and obesity rates have nearly tripled to currently affecting over a third of the global population. Notwithstanding the ever present under-nutrition burden, sub Saharan Africa (SSA) is witnessing a drastic escalation of overweight and obesity. We aimed to explore the prevalence and associated factors for obesity among residents of Dar es Salaam city in Tanzania.Methods Participants from this study were recruited during a community screening conducted in Dar es Salaam. Sociodemographic and clinical data were gathered using a structured questionnaire during enrollment. Dietary habits, anthropometric measurements and blood pressure were assessed. All statistical analyses utilized STATA v11.0 software. Pearson Chi square and Student’s T-test were used to compare categorical and continuous variables respectively. Linear logistic regression analyses were used to assess for factors associated with BMI≥25. All tests were 2-sided and p<0.05 was used to denote a statistical significance.Results A total of 6691 participants were enrolled. The mean age was 43.1 years and males constituted 54.2% of all participants. Over two-thirds of participants were alcohol consumers and 6.9% had a positive smoking history. Eighty eight point three percent of participants were underactive, 4.7% had a history of diabetes mellitus and 18.1% were known to have elevated blood pressure. Overweight and obesity were observed in 34.8% and 32.4% of participants respectively. Among overweight and obese participants, 32.8% had a misperception of having a healthy weight. Age≥40, female sex, a current working status, habitual breakfast skipping, poor water intake, high soft drink consumption, regular fast food intake, low vegetable and fruit consumption, alcohol consumption and elevated blood pressure were found to be independent associated factors for obesity.Conclusion A sizeable proportion of participants were overweight or obese. Concomitantly, the rates of physical inactivity and unhealthy eating are disproportionately high. In view of this, community-based and multilevel public health strategies to promote and maintain healthy eating and physical activity require an urgent step-up in urban Tanzania.

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Prevalence of Hypertension in Children

Hypertension ◽

10.1161/hypertensionaha.118.11673 ◽

2019 ◽

Vol 73 (1) ◽

pp. 148-152 ◽

Cited By ~ 39

Author(s):

Cynthia S. Bell ◽

Joyce P. Samuel ◽

Joshua A. Samuels

Keyword(s):

Blood Pressure ◽

American Academy ◽

Screening Program ◽

Elevated Blood Pressure ◽

Elevated Blood ◽

Older Children ◽

American Academy Of Pediatrics ◽

Fourth Report ◽

Prevalence Estimates ◽

Hypertension In Children

In 2017, the American Academy of Pediatrics issued a new clinical practice guideline for defining hypertension in children as an update to the previous Fourth Report guidelines issued in 2004. Prevalence of confirmed pediatric hypertension in children has ranged from 2% to 4% based on previous guidelines yet it is unknown what the prevalence is under the new guideline. We estimated the prevalence of elevated blood pressure, stage 1, and stage 2 hypertension by the new American Academy of Pediatrics guideline in our school-based blood pressure screening program. New prevalence estimates were compared with Fourth Report prevalence estimates in the same population by sex, age, and height factors. In 22 224 students aged 10 to 17 years screened in school as part of the Houston Pediatric and Hypertension Program at the University of Texas McGovern Medical School, the prevalence of elevated blood pressure (previously called prehypertension) increased from 14.8% by Fourth Report to 16.3% by the new American Academy of Pediatrics guideline. This increase in elevated blood pressure resulted from differential classification changes in younger and older children. Prevalence of confirmed hypertension remains at 2% to 4% in this population, however shorter children <13 years old and taller, older children 13+ years old are systematically more likely to be diagnosed with hypertension by new guidelines.

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Research on the Association between Serum Calcium and Elevated Blood Pressure, Overweight, and Obesity in Koreans

Korean Journal of Family Practice ◽

10.21215/kjfp.2019.9.1.108 ◽

2019 ◽

Vol 9 (1) ◽

pp. 108-113

Author(s):

Seok-Won Son ◽

Ji-Ryang Kim ◽

Young-Mi Eun ◽

Se-Hong Kim

Keyword(s):

Blood Pressure ◽

Serum Calcium ◽

Overweight And Obesity ◽

Elevated Blood Pressure ◽

Elevated Blood

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The prevalence of hypertension and elevated blood pressure and its correlation with overweight/obesity among students aged 6–17 years in Suzhou

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2021-0033 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Cailong Chen ◽

Menglan Lu ◽

Ying Wu ◽

Zheng Zhang ◽

Jia Hu ◽

...

Keyword(s):

Blood Pressure ◽

High School Students ◽

High Blood Pressure ◽

Junior High School ◽

Overweight And Obesity ◽

Lifestyle Changes ◽

Elevated Blood Pressure ◽

World Health ◽

Childhood And Adolescence ◽

Elevated Blood

Abstract Objectives Lifestyle changes have led to an increase in the prevalence of hypertension in Chinese children and adolescents. The aim of this study was to analyze the prevalence of hypertension and its association with overweight and obesity among students aged 6–17 years in Suzhou. This retrospective analysis included physical examination data of primary and junior high school students in Suzhou Industrial Park from 2016 to 2019. Methods Elevated blood pressure and hypertension were defined using blood pressure criteria appropriate for age, sex, and height percentile. Overweight and obesity were defined using the 2007 diagnostic criteria proposed by the World Health Organization for school-age children. Logistic regression analysis was used to evaluate the association between hypertension and overweight and obesity. Results A total of 128,113 students were included. The prevalence of elevated BP and hypertension was 9.92% and 13.56%, respectively. The incidence of high blood pressure was higher in boys than in girls and increased with an increase in body mass index (BMI). The prevalence of hypertension in obese boys and girls (27.07% and 27.49%, respectively) was 2.3-fold and 2.8-fold higher than that in normal-weight boys and girls (11.58% and 9.83%, respectively). Conclusions Blood pressure was positively correlated with BMI, and the risk of high blood pressure due to overweight/obesity was 10.44%. Overweight and obesity significantly increased the risk of hypertension in students aged 6–17 years in Suzhou. Targeted weight-loss programs during childhood and adolescence may reduce the risk of hypertension in adulthood.

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