RESUMO
OBJECTIVES: To assess factors associated with prehypertension and hypertension among children in North Africa. METHODS: An epidemiological observational, school- and college-based study among 3562 healthy children and adolescents to assess factors associated with blood pressure categories (normal, prehypertensive, hypertensive), including perinatal (gestational age, birth weight, breastfeeding) and current lifestyle characteristics (body mass index, time spent watching a screen and time spent exercising). RESULTS: Prevalence of hypertension increased with age from 8.7% between 6-10 years to 14.7% between 11-15 years, and 15.6% above 15 years. Prevalence of prehypertension and hypertension increased with body mass index from 9.9% and 11.5% among children not overweight to 15.6% (RR 1.58, 95% CI 1.24-2.02, P<0.001) and 17.2% (RR 1.50, 95% CI 1.22-1.85, P<0.001) among those overweight and to 26.8% (RR 2.72, 95% CI 2.04-3.64, P<0.01) and 32.3% (RR 2.82, 95% CI 2.27-3.50, P<0.01) among obese children. There was a trend of association of prehypertension with the time spent watching Television, internet and electronic games. Children whose mother or father had a history of hypertension had a trend to be prehypertensive or hypertensive. A parental hypertension was found in 33.6% of normotensive, 38.2% of prehypertensive, and 42.6% of hypertensive children (P=0.05). Children with prehypertension or hypertension were more likely to have a diabetic father or mother (22.8% and 22.6% vs 15.8%, respectively, P=0.01). Also, prehypertension and hypertension were associated with shorter gestational age, early birth, reduced birth weight, and shorter breastfeeding. CONCLUSION: Prehypertension and hypertension have a high prevalence among children in North Africa. They are associated with overweight, obesity, diabetes, a shorter gestational age, a lower birth weight and a shorter breastfeeding.
RESUMO
BACKGROUND: The Saharan adult population is characterized by a high prevalence of hypertension. The aim of the present study was to compare blood pressure (BP) levels in Saharan Arab-origin teenagers, in relationship with Europeans of the same age, and to assess the association with birth weight, body weight, and other anthropometric measurements. METHODS: BP values, heart rate (HR), clinical parameters, and anthropometric measurements were determined in 2,057 teenagers ages 15-19, 1,122 Algerians (388 boys) and 935 Italians (407 boys). Birth weight was obtained from obstetrical records in 568 Algerians and 735 Italians. RESULTS: The European teenagers were significantly taller and heavier than their Algerian counterparts. In the Algerian population, systolic BP (SBP) was higher in boys (P < 0.01) and lower in girls (P < 0.0001) compared to the Italians, whereas diastolic BP (DBP) was higher in Italians (P < 0.001). Both SBP and DBP were higher in boys than in girls independently of geographic origin (P < 0.001). In all four gender and ethnic groups, both SBP and DBP were strongly correlated with weight or body mass index (BMI). Influence of body weight was stronger on SBP than on DBP; in all four groups, those with the highest weight or BMI quartiles had higher SBP levels by 6-12 mm Hg as compared to those individuals in the lowest quartiles. No correlation was found between birth weight, and SBP or DBP. CONCLUSIONS: In Algerian and Italian teenagers, both male and female, current weight but not birth weight was found to be a strong determinant of BP levels.