Determinants of hypertension in school-aged boys and girls in Silesia voivodeship

Abstract

Background Territorial differentiation of arterial hypertension (AH) occurrence in children and adolescents suggests discrepancies in spread of its determinants (host and environmental) in this age group. The aim of the study was to estimate possible risk factors of AH in school-aged children and adolescents in Silesia voivodeship.
Material and methods A cross-sectional study was conducted in the school period 2005/2006 in six randomly chosen schools in four towns in Upper Silesia region. The study comprised 674 children aged 6-18. BP was taken three times a week, using a mercury sphygmomanometer, by Korotkov method, following the guidelines of the current version of Horan’s report. BP mean value, calculated from these measurements, was taken for analysis as the decisive one. Risk factors were assessed on the basis of a questionnaire.
Results Strong positive correlations between BP and body mass (r = 0.4-0.6; p < 0,05), and BMI (r = 0.3-0.6; p < 0,05) were found. The impact of excessive body mass on AH occurrence was confirmed in primary school students (boys: OR = 27.65; 95% CI: 3.03-139.0; p < 0.001 and girls: OR = 3.4; 95% CI: 0.7-16.7; p = 0.08) and junior high school students (boys: OR = 5.7; 95% CI: 1.12–31.0; p = 0.01 and girls: OR = 8.3; 95% CI: 1.1-97.0; p = 0.02). Elevated BP was more frequent in children whose mothers declared higher educational level (boys in junior high school: OR = 6.06; 95% CI: 0.7–136.0; p = 0,06 and girls in primary school: OR = 5.12; 95% CI: 0.85-39.0; p = 0.04). The influence of familiar occurrence of heart diseases on AH was of great importance in junior high school boys (OR = 43.3; 95% CI: 3.67-117.0; p < 0.001). We did not reveal the impact of breastfeeding, birth weight and socioeconomic status on AH prevalence in the surveyed children.
Conclusions The most marked influence on BP in the students was observed in relation to their age, body mass, BMI, parents’ educational level and familial occurrence of heart diseases and obesity. The obtained results confirm the thesis of territorial discrepancies in the occurrence of AH risk factors.