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      Prevalence of High Blood Pressure in 122,053 Adolescents: A Systematic Review and Meta-Regression

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          Abstract

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          Abstract

          Several studies have reported high prevalence of risk factors for cardiovascular disease in adolescents.

          To perform: i) systematically review the literature on the prevalence of high blood pressure (HBP) in adolescents; ii) analyze the possible methodological factors associated with HBP; and iii) compare the prevalence between developed and developing countries.

          We revised 10 electronic databases up to August 11, 2013.

          Only original articles using international diagnosis of HBP were considered. The pooled prevalence's of HBP were estimated by random effects. Meta-regression analysis was used to identify the sources of heterogeneity across studies.

          Fifty-five studies met the inclusion criteria and total of 122,053 adolescents included. The pooled-prevalence of HBP was 11.2%, 13% for boys, and 9.6% for girls ( P < 0.01). Method of measurement of BP and year in which the survey was conducted were associated with heterogeneity in the estimates of HBP among boys.

          The data indicate that HBP is higher among boys than girls, and that the method of measurement plays an important role in the overall heterogeneity of HBP value distributions, particularly in boys.

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          Most cited references95

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          The role of conceptual frameworks in epidemiological analysis: a hierarchical approach.

          C Victora, S Huttly, Charles S. Fuchs … (1997)
          This paper discusses appropriate strategies for multivariate data analysis in epidemiological studies. In studies where determinants of disease are sought, it is suggested that the complex hierarchical inter-relationships between these determinants are best managed through the use of conceptual frameworks. Failure to take these aspects into consideration is common in the epidemiological literature and leads to underestimation of the effects of distal determinants. An example of this analytical approach, which is not based purely on statistical associations, is given for assessing determinants of mortality due to diarrhoea in children. Conceptual frameworks provide guidance for the use of multivariate techniques and aid the interpretation of their results in the light of social and biological knowledge.
          Article 0 comments Cited 245 times – based on 0 reviews     Review now
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            Prevalence of hypertension and pre-hypertension among adolescents.

            Karen L McNiece, Timothy S Poffenbarger, Jennifer Turner … (2007)
            To determine the prevalence of hypertension and pre-hypertension on the basis of the 2004 National High Blood Pressure Education Program Working Group guidelines in an adolescent school-screening population. Cross-sectional assessment of blood pressure (BP) in 6790 adolescents (11-17 years) in Houston schools was conducted from 2003 to 2005. Initial measurements included height, weight, and 4 oscillometric BP readings. Repeat measurements were obtained on 2 subsequent occasions in students with persistently elevated BP. Final prevalence was adjusted for loss to follow-up and logistic regression used to assess risk factors. BP distribution at initial screen was 81.1% normal, 9.5% pre-hypertension, and 9.4% hypertension (8.4% Stage 1; 1% Stage 2). Prevalence after 3 screenings was 81.1% normal, 15.7% pre-hypertension, and 3.2% hypertension (2.6% Stage 1; 0.6% Stage 2). Hypertension and pre-hypertension increased with increasing body mass index. Sex, race, and classification as either at-risk for overweight or overweight were independently associated with pre-hypertension. Only classification as overweight was associated with hypertension. Application of new classification guidelines for adolescents with elevated BP reveals approximately 20% are at risk for hypertension. Further research determining the significance of each BP category and refining definitions to account for BP variability is warranted.
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              Trends in blood pressure among children and adolescents.

              Paul Muntner, Jiang He, Jeffrey A Cutler … (2004)
              The prevalence of overweight among children and adolescents increased between 1988 and 2000. The change in blood pressure among children and adolescents over that time and the role of overweight is unknown. To examine trends in systolic and diastolic blood pressure among children and adolescents between 1988 and 2000. Two serially conducted cross-sectional studies using nationally representative samples of children and adolescents, aged 8 to 17 years, from the third National Health and Nutrition Examination Survey (NHANES III) conducted in 1988-1994 (n = 3496) and NHANES 1999-2000 (n = 2086). Systolic and diastolic blood pressure levels. In 1999-2000, the mean (SE) systolic blood pressure was 106.0 (0.3) mm Hg and diastolic blood pressure was 61.7 (0.5) mm Hg. After adjustment for age, mean systolic blood pressure was 1.6 mm Hg higher among non-Hispanic black girls (P =.11) and 2.9 mm Hg higher among non-Hispanic black boys (P<.001) compared with non-Hispanic whites. Among Mexican Americans, girls' systolic blood pressure was 1.0 mm Hg higher (P =.21) and boys' was 2.7 mm Hg higher (P<.001) compared with non-Hispanic whites (P<.001). With further adjustment for body mass index, these differences were attenuated. After age, race/ethnicity, and sex standardization, systolic blood pressure was 1.4 (95% confidence interval [CI], 0.6-2.2) mm Hg higher (P<.001) and diastolic blood pressure was 3.3 (95% CI, 2.1-4.5) mm Hg higher in 1999-2000 (P<.001) compared with 1988-1994. With further adjustment for differences in the body mass index distribution in 1988-1994 and 1999-2000, the increase in systolic blood pressure was reduced by 29% and diastolic blood pressure was reduced by 12%. Blood pressure has increased over the past decade among children and adolescents. This increase is partially attributable to an increased prevalence of overweight.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Medicine (Baltimore)
                Journal ID (iso-abbrev): Medicine (Baltimore)
                Journal ID (publisher-id): MEDI
                Title: Medicine
                Publisher: Wolters Kluwer Health
                ISSN (Print): 0025-7974
                ISSN (Electronic): 1536-5964
                Publication date Collection: December 2014
                Publication date (Electronic): 12 December 2014
                Volume: 93
                Issue: 27
                Electronic Location Identifier: e232
                Affiliations
                From the School of Medicine of the University of São Paulo (FMUSP)—Department of Preventive Medicine, São Paulo, Brazil (ACFdeM, MBL, HBC); YCARE (Youth/Child and cARdiovascular Risk and Environmental) Research Group, FMUSP/Brazil (ACFdeM, MBL, HBC); Faculty of Health of the University of Zaragoza, GENUD—Growth, Exercise, Nutrition and Development, Zaragoza, Spain (ACFdeM, LAM); Visiting Professor, School of Medicine of the University of São Paulo—Department of Preventive Medicine, São Paulo, Brazil (LAM); and School of Medicine of the Federal University of Pelotas, Pelotas, Brazil (BLH).
                Author notes
                Correspondence: Augusto César Ferreira de Moraes, Faculdade de Medicina da USP—Departamento de Medicina Preventiva, 2° andar, sala 2162—Secretaria de Pós-Graduação, Av. Dr. Arnaldo, 455—Cerqueira César, São Paulo/SP, Brazil (e-mail: augustocesar.demoraes@ 123456usp.br ).
                Article
                Accession ID: 00232
                DOI: 10.1097/MD.0000000000000232
                PMC ID: 4602805
                PubMed ID: 25501086
                SO-VID: 4099fb49-2292-4833-9ca2-cc91ef9bfff4
                Copyright © Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
                License:

                This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0, where it is permissible to download, share and reproduce the work in any medium, provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/4.0

                History
                Date received : 6 August 2014
                Date revision received : 1 October 2014
                Date accepted : 2 October 2014
                Categories
                Subject: 4700
                Subject: Article
                Subject: Meta-Analysis of Observ Studies in Epidemiology
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