Epidemiology of elevated blood pressure and associated risk factors in Chinese children: the SNEC study

Abstract

Despite the association of childhood blood pressure (BP) with hypertension later in the life course, there remains dearth of information regarding the prevalence and emergence of hypertension in children, especially in China. To investigate the current status of BP, prevalence of elevated BP and related factors in Chinese children, a cross-sectional survey in a representative sample of 9354 Chinese children 5-17 years old was conducted in seven cities in Northeastern China during 2011 and 2012. BP measurements were taken by mercury sphygmomanometer. Elevated BP in children was defined as an average diastolic BP or systolic BP that is in the 95th percentile or higher for their gender, age and height. Overall, total prevalence of elevated BP was 13.8%, and no significant difference between males and females was identified. Multivariate analyses revealed that children having a higher area of residence had a lower of elevated BP. Increased odds for elevated BP were found for individuals who were lean (odds ratio (OR)=2.12; 95% confidence interval (CI): 1.67-2.69), overweight (OR=2.05; 95% CI: 1.74-2.42), obese (OR=3.15; 95% CI: 2.70-3.68), were born with low birth weight (OR=1.26; 95%CI: 1.01-1.63), premature birth (OR=1.46; 95%CI: 1.13-1.88), and were with home coal use (OR=1.24; 95%CI: 1.02-1.52). In conclusion, elevated BP was found to be prevalent in children in urban areas of Northeast China. These results underscore the importance of implementing a package of measures aimed at reducing malleable risk for this cardiovascular condition in school-aged children in Northeast China.

Low Birthweight Is Associated with Higher Risk of High Blood Pressure in Chinese Girls: Results from a National Cross-Sectional Study in China

“…It has always been of interest to explore the association between LBW and later HBP, and the results of previous studies are varied. One study conducted in Jerusalem found that LBW had little influence on blood pressure in adolescents aged 17 [16], while another study found being born small for one’s gestational age may be a predictor of raised blood pressure when an individual is in their early 30s [24]. Both conclusions were supported by numbers found in later studies [25,26,27,28].…”

“…However, some studies have showed little effect of LBW on blood pressure in young adults [9,10]. On the other hand, some recent studies suggest that the co-existence of low birthweight and later obesity, rather than low birthweight itself, was a strong risk factor of HBP during adolescence [11,12,13,14,15,16,17]. The relationship between LWB and HBP remains unclear, and obesity during school-age is seldom brought into consideration.…”

Birth Weight and Birth Weight for Gestational Age in Relation to Risk of Hospitalization with Primary Hypertension in Children and Young Adults

“…Epidemiologic studies have reported an increased risk of childhood-onset primary (essential) hypertension in low birth weight infants (Edvardsson, Steinthorsdottir, Eliasdottir, Indridason, & Palsson, 2012; R. R. Huxley, Shiell, & Law, 2000; Mu et al, 2012; Zhou et al, 2015), possibly due to alterations in their renal or vascular systems related to reduced growth in utero (Barker, Bagby, & Hanson, 2006; Edvardsson et al, 2012; Hughson, Farris, Douglas-Denton, Hoy, & Bertram, 2003; Kaplan, 2014; Norman, 2008). Less clear however, is whether high birth weight, which may have long-term adverse metabolic effects, such as insulin resistance (Darendeliler et al, 2009; Mandy, 2014), is also a risk factor for the development of primary hypertension in childhood (Edvardsson et al, 2012).…”

Weight status, cardiorespiratory fitness and high blood pressure relationship among 5–12-year-old Chinese primary school children

“…High blood pressure (HBP) is increasing in prevalence among children and youth, and there is evidence that HBP is present in Chinese children as young as 5 years old 1 .…”