To ascertain the prevalence and fundamental determinants of arterial hypertension (Ht) in children and adolescents.Objective:
Table: Determinants of elevated blood pressure through logistic regression.Design and method:
Cross-sectional assessment of blood pressure (BP) in 15.049 portuguese children and adolescents, mean age 13.02 ± 2.05 years (5–17 years), body mass index (BMI) 19.22 ± 3.60 Kg/m2, mostly male (73%). BP and heart rate were measured three times after a 10-minute resting period, with a validated automatic blood pressure monitor (OMRON 705IT) and an appropriately sized cuff over the brachial artery. About 26% of the youngsters were amateur registered athletes and 20% had family history of cardiovascular diseases (mainly Ht). All participants were clinically evaluated by the same clinician, warranting an uncommon high degree of reproducibility of the clinical evaluations.Results:
Mean BP was 112.82 ± 9.27 mmHg and 70.42 ± 6.49 mmHg, for systolic and diastolic BP. Mean heart rate (HR) was 70.32 ± 18.01 bpm. BP distribution was 15.7% Ht (12.5% stage 1, 3.2% stage 2), 15.3% high-normal, and 69% normal. The distribution of Ht and high-normal BP was slightly higher in males (16.2% and 16.1%, respectively) than females (14.1% and 13.1%, respectively; p = 0.001). Overweight and at-risk weight classification accounted respectively for 6.3% and 13.6% of the cohort. The determinants of elevated BP were assessed through logistic regression (cf. table). Male sex, increased BMI, no regular physical activity and family history of Ht were the main determinants of elevated BP. Considering the BMI, a 7.6% increase in the risk of Ht and a 7.5% increase in the risk of high-normal BP per 1 kg/m2 of BMI were also documented.Conclusions:
The proportion of children with BP above the 90th percentile was high, with an overall prevalence of Ht of 15.7%, related to overweight, physical inactivity, male gender and family history of Ht.