Vol 13, No 1 (2009)
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Published online: 2008-12-12

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The prevalence of high blood pressure readings in children and adolescents attending primary and secondary schools in Kwidzyn

Artur Młodzianowski, Krzysztof Narkiewicz, Aleksandra Żurowska
Nadciśnienie tętnicze 2009;13(1):3-10.

Abstract

Background Epidemiological data confirm that hypertension is one of the major risk factors for strokes, myocardial infarction, heart failure and/or chronic kidney disease. Hypertension in children is defined as systolic blood pressure or/and diastolic blood pressure equal or greater than the 95th percentile for sex, age, and height on at least three separate occasions. Polish epidemiological data show prevalence between 1% and 8% for hypertension in the pediatric population. In the last 10 years, an increased prevalence of primary hypertension has been reported in this age group, which has been associated with co-existing overweight and obesity.
Material and methods The analyzed cohort of 3232 children and adolescents included the total school population of Kwidzyn. The age of the examined children varied from 9.8 to 16.5 years. 47.5% were girls and 52.5% boys. Blood pressure was obtained with automatic oscillometric devices. The measurements were performed according to the guidelines of the IV Task Force on Diagnosis and Treatment of High Blood Pressure in Children and Adolescents. Measurements were repeated 3 times during a single visit at 2 minutes intervals. The mean value of the second and the third measurement was used for the analysis. A history for hypertension and diabetes was noted among family members of the studied cohort.
Results 26.1% of girls and 23.5% of boys had blood pressure readings over the 95. centile for age and height. The percentage of readings over the 95. centile was significantly higher in younger children. Among family members hypertension was reported in 7.6% of women, 12.2% of men and 0.5% of children and diabetes in 0.9% of women; 1.7% of men and 0.2% of children.
Conclusions
1. A high percentage of children demonstrate systolic and/or diastolic blood pressure over the 95. centile for sex, age and height with repeated measurements performed at a single visit.
2. Elevated blood pressure readings in children require exclusion of white coat hypertension.
3. The adequate interpretation of blood pressure readings in Polish children requires collection of normative data for oscillometric measurements in the pediatric population.
4. The knowledge of health issues associated with hypertension among the studied cohort is insufficient.

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