Differences in prevalence of prehypertension and hypertension in children and adolescents in the eastern, central and western regions of China from 1991-2011 and the associated risk factors

Abstract

The present study aimed to estimate the differences in rates of prehypertension and hypertension in children and adolescents among three regions with different socioeconomic status in China, and explore the corresponding risk factors associated with prehypertension and hypertension to guide the prevention. Blood pressure measurements of 13 762 children and adolescents aged 6–17 years were obtained from a prospective national survey (the China Health and Nutrition Survey, 1991–2011). Prehypertension and hypertension were defined by age and gender, according to China’s standard criteria. Chi-square tests were used to compare the differences in the prevalence of prehypertension and hypertension among three regions. Trend chi-square tests were used to detect the trends in rates of prehypertension and hypertension over survey years. Logistic regression models were used to detect the potential risk factors of prehypertension and hypertension in children and adolescents. During the survey years, the overall prevalence of prehypertension and hypertension were 6.0% and 10.6%. The corresponding rates in the western region were lowest, but increased rapidly over the two decades (84.0% and 122.6% increases respectively, P<0.001). The overall hypertension rate remained high in the eastern region, despite the slower increase (24.2% increase). In the central region, although the prehypertension rate remained stable, the rate of hypertension had a 94.8% increase these years (P<0.0001). According to the results of logistic regression, age, body mass index (BMI) and waist/height ratio (WHtR) were associated with prehypertension and hypertension. Children and adolescents in the eastern region had the highest level of prehypertension and hypertension, while the rapid increase of blood pressure in the western and central regions were also supposed to concern. Improvement of the healthy lifestyle is urgent for prehypertension and hypertension prevention in children and adolescents.

Association Between Abdominal Waist Circumference and Blood Pressure In Brazilian Adolescents With Normal Body Mass Index

“…The prevalence of high blood pressure among adolescents is increasing [3]. In our study, the prevalence of elevated BP was compatible with recent reports which grouped pre-hypertensive and hypertensive status in the analysis [25,26]; and also with the total population of ERICA study, in which 14.5% pre-hypertensive and 9.6% hypertensive adolescents were identified, aiming total prevalence of elevated BP of 24.1% [14]. Despite that, it is a not common practice to screen for hypertension among children and adolescents routinely [27].…”

Undiagnosed prehypertension/hypertension in Canadian adolescents: The critical role of the public health nurse

“…Given the modifiable risk factors of prehypertension/hypertension, the increase in prevalence is alarming. Contributing modifiable risk factors to the development of adolescent prehypertension/hypertension have been widely identified as a lack of physical exercise resulting in a high prevalence of childhood obesity (Dionne et al., 2017; Pescatello et al., 2019; Twig et al., 2016), increased sodium intake (Dionne et al., 2017; Falkner, 2015; Fan, Liao, Zong, & Zhang, 2019), and increased blood glucose measurements (Jobe, Agbla, Prentice, & Hennig, 2017; Simental‐Mendía et al., 2019; Yan et al., 2015).…”

“…One cross‐sectional study, based in an urban city in Iran, reported over 15% of children aged 7–17 years old as having undiagnosed prehypertension/hypertension (Badeli et al., 2016). BP measurements of children and adolescents were obtained from a National prospective survey from three regions in China and these data were used to compare the prevalence and trajectories of child and adolescent prehypertension/hypertension from 1991 to 2011; a significant increase in adolescent hypertension was found in every region (Fan et al., 2019). A recent systematic review explored the prevalence of prehypertension/hypertension in children and adolescents across the globe and found a secular increase over the last two decades (Song et al., 2019).…”

“…A recent systematic review explored the prevalence of prehypertension/hypertension in children and adolescents across the globe and found a secular increase over the last two decades (Song et al., 2019). These international studies described above suggest increasing trends of undiagnosed adolescent prehypertension/hypertension and a need to begin screening for undiagnosed prehypertension/hypertension in rural, urban, and suburban settings (Fan et al., 2019; Sivasankaran, 2019). However, literature reporting the prevalence of adolescent prehypertension/hypertension remains minimal within Canada.…”

“…These international studies described above suggest increasing trends of undiagnosed adolescent prehypertension/hypertension and a need to begin screening for undiagnosed prehypertension/ hypertension in rural, urban, and suburban settings (Fan et al, 2019;Sivasankaran, 2019). However, literature reporting the prevalence of adolescent prehypertension/hypertension remains minimal within Canada.…”