Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-28T09:59:00.188Z Has data issue: false hasContentIssue false

Arterial hypertension in school-aged children in western Romania

Published online by Cambridge University Press:  13 July 2012

Adela Chirita-Emandi*
Affiliation:
Department of Pediatrics, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania Department of Pediatrics, Emergency Hospital for Children “Louis Turcanu”, Timisoara, Romania
Maria Puiu
Affiliation:
Department of Pediatrics, Emergency Hospital for Children “Louis Turcanu”, Timisoara, Romania Department of Genetics, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania
Mihai Gafencu
Affiliation:
Department of Pediatrics, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania Department of Pediatrics, Emergency Hospital for Children “Louis Turcanu”, Timisoara, Romania
Corina Pienar
Affiliation:
Department of Pediatrics, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania Department of Pediatrics, Emergency Hospital for Children “Louis Turcanu”, Timisoara, Romania
*
Correspondence to: Dr A. Chirita-Emandi, MD, PhD Student, Department of Endocrinology, Emergency Hospital for Children “Louis Turcanu”, Street Iosif Nemoianu number 2, 300011 Timisoara, Romania. Tel: +0040724369599; Fax: +0040256497818; E-mail: [email protected]

Abstract

Aim

To describe the current prevalence of paediatric hypertension and the relationships between body mass index, gender, place of residence, and blood pressure in a population of school-aged children from western Romania.

Material and method

A total of 3626 children from Timisoara and the surrounding regions were examined by medical students from February, 2010 to June, 2011. Children's body mass index was interpreted on the basis of reference guidelines from Centers for Disease Control and Prevention. Blood pressure measurements were taken by the auscultation method. For defining elevated blood pressure, we used the standards published in the Fourth Report.

Results

Overall, the prevalence of overweight was 14% and 11.8% for obesity. Boys had a higher prevalence of both overweight and obesity compared with girls. The prevalence of hypertension on our screening was 9.1% higher in boys and urban residence. The prevalence of pre-hypertension was 6.5%. With regard to body mass index, 21.1% of obese, 12.8% of overweight, and 7.1% of normal weight children presented hypertension. The strongest determinant of hypertension was body mass index percentile. Significant odds ratio was found for obesity (3.93; confidence interval: 3.11–4.95), urban residence (1.68; confidence interval: 1.35–2.1), and male gender (1.34; confidence interval: 1.12–1.6).

Conclusions

The results confirm a worrisome prevalence of overweight and obesity among children in Romania, accompanied by an alarming prevalence of hypertension. Overweight and obesity, male gender, and urban residence were the major contributing factors for the overall high prevalence of hypertension found. Our results point to the urgent need to adopt strategies aimed at preventing hypertension and obesity in children in Romania.

Type
Original Article
Copyright
Copyright © Cambridge University Press 2012 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Swinburn, BA, Sacks, G, Hall, KD, et al. The global obesity pandemic: shaped by global drivers and local environments. Lancet 2011; 378: 804814.Google Scholar
2. Wang, Y, Lobstein, T. Worldwide trends in childhood overweight and obesity. Int J Pediatr Obes 2006; 1: 1125.Google Scholar
3. Freedman, DS, Katzmarzyk, PT, Dietz, WH, Srinivasan, SR, Berenson, GS. Relation of body mass index and skinfold thickness to cardiovascular disease risk factors in children: the Bogalusa Heart Study. Am J Clin Nutr 2009; 90: 210216.CrossRefGoogle ScholarPubMed
4. Berenson, GS. Health consequences of obesity. Pediatric Blood & Cancer 2012; 58: 117121.CrossRefGoogle ScholarPubMed
5. Kotsis, V, Stabouli, S, Papakatsika, S, Rizos, Z, Parati, G. Mechanisms of obesity-induced hypertension. Hypertens Res 2010; 33: 386393.Google Scholar
6. Bibbins-Domingo, K, Coxson, P, Pletcher, MJ, Lightwood, J, Goldman, L. Adolescent overweight and future adult coronary heart disease. N Engl J Med 2007; 357: 23712379.CrossRefGoogle ScholarPubMed
7. Muntner, P, He, J, Cutler, JA, Wildman, RP, Whelton, PK. Trends in blood pressure among children and adolescents. J Am Med Assoc 2004; 291: 21072113.Google Scholar
8. Din-Dzietham, R, Liu, Y, Bielo, M-V, Shamsa, F. High blood pressure trends in children and adolescents in national surveys, 1963 to 2002. Circulation 2007; 116: 14881496.Google Scholar
9. Chiolero, A, Bovet, P, Paradis, G, Paccaud, F. Has blood pressure increased in children in response to the obesity epidemic? Pediatrics 2007; 119: 544553.Google Scholar
10. Flechtner-Mors, M, Thamm, M, Wiegand, S et al. Comorbidities related to body mass index category in children and adolescents: German/Austrian/Swiss Obesity Register APV compared to the German KiGGS Study. Hormone Research in Paediatrics, 2011: published online. Available from http://content.karger.com/produktedb/produkte.asp?typequalfulltext&fileequal000334147 Google Scholar
11. Bancalari, R, Díaz, C, Martínez-Aguayo, A, et al. Prevalence of hypertension in school age children and its association with obesity. Rev Med Chil 2011; 139: 872879.Google Scholar
12. Pileggi, C, Carbone, V, Nobile, CGA, Pavia, M. Blood pressure and related cardiovascular disease risk factors in 6–18 year-old students in Italy. J Paediatr Child Health 2005; 41: 347352.CrossRefGoogle ScholarPubMed
13. Ivan, A, Duda, R, Groll, M, et al. Epidemiology of essential arterial hypertension in collectives of schoolchildren. The prevalence of blood pressure changes. Rev Pediatr Obstet Ginecol Pediatr 1989; 38: 247254.Google ScholarPubMed
14. de Onis, M, Onyango, AW, Borghi, E, Garza, C, Yang, H. Reliability of anthropometric measurements in the WHO Multicentre; Growth Reference Study. Acta Paediatr Suppl 2006; 450: 3846.Google Scholar
15. National Center for Health Statistics, Centers for Disease Control and Prevention. Centers for Disease Control and Prevention growth charts: United States. National Center for Health Statistics, Hyattsville, MD, United States, 2000. Available from www.cdc.gov/growthcharts.Google Scholar
16. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 2004; 114 (2 Suppl, 4th Report): 555–576.CrossRefGoogle Scholar
17. Clark, JA, Lieh-Lai, MW, Sarnaik, A, Mattoo, TK. Discrepancies between direct and indirect blood pressure measurements using various recommendations for arm cuff selection. Pediatrics 2002; 110: 920923.Google Scholar
18. de Onis, M, Blössner, M. Prevalence and trends of overweight among preschool children in developing countries. Am J Clin Nutr 2000; 72: 10321039.Google Scholar
19. Kovács, VA, Gábor, A, Fajcsák, Z, Martos, E. Sport habits and sedentary lifestyle among elementary school children in Obuda, Hungary. Orv Hetil 2010; 151: 652658.Google Scholar
20. Kisić-Tepavcević, D, Jovanović, N, Kisić, V, et al. The prevalence of childhood obesity in a sample of schoolchildren in Belgrade. Srp Arh Celok Lek 2008; 136: 621624.Google Scholar
21. Cacciari, E, Milani, S, Balsamo, A, et al. Italian cross-sectional growth charts for height, weight and body mass index (2 to 20 yr). J Endocrinol Invest 2006; 29: 581593.Google Scholar
22. Mészáros, Z, Mészáros, J, Völgyi, E, et al. Body mass and body fat in Hungarian schoolboys: differences between 1980–2005. Journal of Physiological Anthropology 2008; 27: 241245.Google Scholar
23. Lutfiyya, MN, Lipsky, MS, Wisdom-Behounek, J, Inpanbutr-Martinkus, M. Is rural residency a risk factor for overweight and obesity for U.S. Children? Obesity 2007; 15: 23482356.Google Scholar
24. Reed, DB, Patterson, PJ, Wasserman, N. Obesity in rural youth: looking beyond nutrition and physical activity. J Nutr Educ Behav 2011; 43: 401408.CrossRefGoogle ScholarPubMed
25. Twells, LK, Newhook, LA. Obesity prevalence estimates in a Canadian regional population of preschool children using variant growth references. BMC Pediatr 2011; 11: 21.Google Scholar
26. Marras, AR, Bassareo, PP, Ruscazio, M. The prevalence of paediatric hypertension, emphasising the need to use specific population references: the Sardinian Hypertensive Adolescents Research Program study. Cardiol Young 2009; 19: 233238.Google Scholar
27. Sinha, MD, Reid, CJ. At what level of blood pressure should hypertension be defined in children? Cardiol Young 2009: 428430.Google Scholar
28. Ogden, CL, Flegal, KM, Carroll, MD, Johnson, CL. Prevalence and trends in overweight among US children and adolescents, 1999–2000. J Am Med Assoc 2002; 288: 17281732.Google Scholar
29. Sorof, JM, Lai, D, Turner, J, Poffenbarger, T, Portman, RJ. Overweight, ethnicity, and the prevalence of hypertension in school-aged children. Pediatrics 2004; 113: 475482.Google Scholar
30. Olshansky, SJ, Passaro, DJ, Hershow, RC, et al. A potential decline in life expectancy in the United States in the 21st century. N Engl J Med 2005; 352: 11381145.Google Scholar