Prevalence of arterial hypertension among Brazilian adolescents: systematic review and meta-analysis

Abstract

BackgroundCardiovascular diseases are the leading cause of death in the world and are responsible for a high number of disability-adjusted life years. Elevated blood pressure is an independent, linear and continuous risk factor for cardiovascular disease and has also been reported in the young population. Brazil is a country of continental dimensions, and is very heterogeneous with respect to socioeconomic and cultural aspects. Brazilian studies on the subject of hypertension in adolescence are not nationally representative, and this provides a rationale for the conduction of a meta-analysis to assess the magnitude of the problem in the country.MethodsHypertension studies in adolescents published from 1990 to September 2010 were searched in six electronic databases. Forest plots of the prevalence of hypertension were built for the overall population and by gender. Heterogeneity was assessed using I2 statistics. Meta-regression models were adjusted in order to identify possible sources of heterogeneity.ResultsOf 3,631 articles initially identified, 17 were considered eligible for systematic review. The pooled prevalence of hypertension, estimated through random effects models, was 8.12% (95% CI 6.24 - 10.52) for the total population. Overall, prevalence was higher in males, 8.75% (95% CI 5.81 - 12.96) than females, 6.31%, (95% CI 4.41 - 8.96). Several variables were investigated in the heterogeneity analysis: region of the study, sample size, age and method of blood pressure measurement. The only variables that partially and inconsistently explained the observed heterogeneity (I2 = 95.3%) were the region of the country where the study was conducted and sample.ConclusionsThere was a large variation in hypertension prevalence and in the methods used for its evaluation throughout studies with Brazilian adolescents, indicating the need for standardized procedures and validated methods for hypertension measurement. Despite the large observed heterogeneity, and the small number of studies in some regions of Brazil, the pooled prevalence found in both males and females shows that systemic arterial hypertension should be monitored in the population aged 10–20 years and that specific measures are required to prevent and control the disease, as well as its risk factors. Studies that compare regional heterogeneities may contribute to the knowledge of factors associated with increased blood pressure among adolescents.

High blood pressure in school children and adolescents in Argentina over the past 25 years: A systematic review of observational studies

“…[27][28][29] This systematic analysis of the prevalence of HBP in children and adolescents is an attempt to compensate the lack of national data on pediatric AHT in our country. However, results may not adequately represent indigenous or rural populations given that analyzed data were obtained from studies conducted in urban areas of Argentina.…”

Presión arterial elevada en niños y adolescentes escolarizados de Argentina en los últimos 25 años: revisión sistemática de estudios observacionales

“…[27][28][29] Este análisis sistemático de la prevalencia de PAE en niños y adolescentes es un intento de suplir la falta de datos nacionales sobre la HTA pediátrica en nuestro país. Sin embargo, los resultados no representarían adecuadamente a las poblaciones de comunidades aborígenes o poblaciones rurales, debido a que los datos analizados provienen de estudios realizados en zonas urbanas de Argentina.…”

Revisão Sistemática Sobre a Epidemiologia Das Doenças Cardiovasculares E Respiratórias E Suas Associações Com a Poluição Do Ar Em Vitória/Es

“…Diversas revisões sobre a prevalência de hipertensão no Brasil têm sido publicadas, englobando dados de diversas cidades e regiões [37][38][39][40] . Dessas, a mais abrangente foi a revisão sistemática publicada por Picon et al 41 , cujo objetivo foi estimar a prevalência de hipertensão em todo o território nacional, englobando dados de diversas cidades brasileiras e considerando diversos critérios diagnósticos.…”

“…Comparações similares podem ser feitas para estratos de idade específicos, visto que metanálises abrangentes foram publicadas sobre a prevalência de hipertensão em adolescentes 40 e idosos 39 em escala nacional. Deve-se notar que a presente revisão não realizou metanálises específicas a essas populações.…”

“…Ainda assim, é possível comparar os dados dos estudos individuais conduzidos em Vitória com as estimativas nacionais. Com relação à prevalência de hipertensão em adolescentes brasileiros, a estimativa calculada por Magliano et al 40 foi de 8,1% (IC95%: 6,2-10,5) para a população geral, com pequenas variações entre homens (8,7%; IC95%: 5,8-13,0) e mulheres (6,3%, IC95%: 4,4-9,0). Em comparação aos estudos conduzidos em Vitória, as estimativas apresentam amplitude maior do que a encontrado em âmbito nacional, variando de 3,4-14,8% nos quatro estudos abordando adolescentes 21,22,24,25 .…”