Blood pressure tracking in urban black South African children: birth to twenty cohort

BMC Pediatrics

Shane A Norris¹  John M Pettifor¹  Mogi G Musa¹  Linda S Adair²  Juliana Kagura¹ 

[1] Department of Paediatrics and Child Health, MRC/Wits Developmental Pathways for Health Research Unit, University of the Witwatersrand, 7 York Road, Johannesburg 2193, South Africa;Department of Nutrition, University of North Carolina, Chapel Hill, NC, USA

关键词: Tracking;    Hypertension;    Blood pressure;    Paediatric;   

Others  :  1219312
DOI  :  10.1186/s12887-015-0402-z

 received in 2014-12-02, accepted in 2015-07-06,  发布年份 2015

【 摘 要 】

Background

Hypertension is an emerging public health problem in South Africa. Recent evidence from longitudinal studies has shown that hypertension in adulthood can be traced back to childhood. There is scarcity of longitudinal data on paediatric blood pressure (BP) particularly in African populations. The objective of this study is to assess the prevalence of hypertension and evaluate BP tracking between childhood and late adolescence among South African black Children.

Methods

This study utilized data from the Birth to Twenty cohort, which is comprised of children born in Soweto, Johannesburg in 1990 (N = 3273, 78.5 % black). Data on BP and anthropometry were collected at six follow-up periods between ages 5 and 18 years. Blood pressure status was classified using the Fourth report on National High Blood pressure program in children and adolescents. Pearson correlation coefficients and relative risk ratios (RR) were used to describe tracking of BP between childhood and late adolescence.

Results

The overall point prevalence ranged from 9.2 to 16.4 % for prehypertension and 8.4 to 24.4 % for hypertension. Tracking coefficients ranged from 0.20 to 0.57 for SBP and 0.17- 0.51 for DBP in both sexes over the 14 years of measurement. The proportion of children who maintained an elevated BP status between childhood, adolescence and age 18 years ranged from 36.1 % at age 5 years to 56.3 % at age 13 years. Risk of having elevated BP at 18 years ranged from; RR: 1.60 (95 % CI: 1.29–2.00) at 5 years to RR: 2.71 (95 % CI: 2.32–3.17) at 14 years of age.

Conclusions

This study reports high prevalence of elevated BP which tracks from early childhood into late adolescence. These findings emphasize the importance of early identification of children at risk of developing elevated BP and related risk factors plus timely intervention to prevent hypertension in adulthood.

【 授权许可】

   
2015 Kagura et al.

【 参考文献 】

• [1]Muntner P, He J, Cutler JA, Wildman RP, Whelton PK. Trends in blood pressure among children and adolescents. JAMA. 2004; 291(17):2107-2113.
• [2]Falkner B. Children and adolescents with obesity-associated high blood pressure. J Am Soc Hypertens. 2008; 2(4):267-274.
• [3]Lane DA, Gill P. Ethnicity and tracking blood pressure in children. J Hum Hypertens. 2004; 18(4):223-228.
• [4]Taksande A, Chaturvedi P, Vilhekar K, Jain M. Distribution of blood pressure in school going children in rural area of Wardha district, Maharashatra, India. Ann Pediatr Cardiol. 2008; 1(2):101-106.
• [5]Juhola J, Magnussen CG, Viikari JS, Kahonen M, Hutri-Kahonen N, Jula A, Lehtimaki T, Akerblom HK, Pietikainen M, Laitinen T et al.. Tracking of serum lipid levels, blood pressure, and body mass index from childhood to adulthood: the Cardiovascular Risk in Young Finns Study. J Pediatr. 2011; 159(4):584-590.
• [6]Webber LS, Cresanta JL, Voors AW, Berenson GS. Tracking of cardiovascular disease risk factor variables in school-age children. J Chronic Dis. 1983; 36(9):647-660.
• [7]Lauer RM, Clarke WR. Childhood risk factors for high adult blood pressure: the Muscatine Study. Pediatrics. 1989; 84(4):633-641.
• [8]Lee MH, Kang DR, Kim HC, Ahn SV, Khaw KT, Suh I. A 24-year follow-up study of blood pressure tracking from childhood to adulthood in Korea: the Kangwha Study. Yonsei Med J. 2014; 55(2):360-366.
• [9]Chen X, Wang Y. Tracking of blood pressure from childhood to adulthood: a systematic review and meta-regression analysis. Circulation. 2008; 117(25):3171-3180.
• [10]Lloyd-Sherlock P, Beard J, Minicuci N, Ebrahim S, Chatterji S. Hypertension among older adults in low- and middle-income countries: prevalence, awareness and control. Int J Epidemiol. 2014; 43(1):116-128.
• [11]Sliwa K, Wilkinson D, Hansen C, Ntyintyane L, Tibazarwa K, Becker A, Stewart S. Spectrum of heart disease and risk factors in a black urban population in South Africa (the Heart of Soweto Study): a cohort study. Lancet. 2008; 371(9616):915-922.
• [12]Monyeki KD, Kemper HC, Makgae PJ. The association of fat patterning with blood pressure in rural South African children: the Ellisras Longitudinal Growth and Health Study. Int J Epidemiol. 2006; 35(1):114-120.
• [13]Schutte AE, van Rooyen JM, Huisman HW, Kruger HS, Malan NT, De Ridder JH, Bana C. Dietary risk markers that contribute to the aetiology of hypertension in black South African children: the THUSA BANA study. J Hum Hypertens. 2003; 17(1):29-35.
• [14]Kemp C, Pienaar AE, Schutte A. The prevalence of hypertension and the relationship with body composition in Grade 1 learners in the North West Province of South Africa. South African J Sports Med. 2011; 23(4):117-122.
• [15]Goon D, Amusa L, Mhlongo D, Khoza L, Anyanwu F. Elevated Blood Pressure among Rural South African Children in Thohoyandou, South Africa. Iran J Public Health. 2013; 42(5):489-496.
• [16]Richter L, Norris S, Pettifor J, Yach D, Cameron N. Cohort Profile: Mandela’s children: the 1990 Birth to Twenty study in South Africa. Int J Epidemiol. 2007; 36(3):504-511.
• [17]The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004; 114(2 Suppl 4th Report):555-576.
• [18]Raj M, Sundaram R, Paul M, Kumar K. Blood pressure distribution in Indian children. Indian Pediatr. 2010; 47(6):477-485.
• [19]Urrutia-Rojas X, Egbuchunam CU, Bae S, Menchaca J, Bayona M, Rivers PA, Singh KP. High blood pressure in school children: prevalence and risk factors. BMC Pediatr. 2006; 6:32. BioMed Central Full Text
• [20]Ng’andu NH. Blood pressure levels of Zambian rural adolescents and their relationship to age, sex, weight, height and three weight-for-height indices. Int J Epidemiol. 1992; 21(2):246-252.
• [21]Ellenga Mbolla BF, Okoko AR, Mabiala Babela JR, Ekouya Bowassa G, Gombet TR, Kimbally-Kaky SG, Longo-Mbenza B. Prehypertension and Hypertension among Schoolchildren in Brazzaville, Congo. Int J Hypertens. 2014; 2014:803690.
• [22]Okoh BA, Alikor EA, Akani N. Prevalence of hypertension in primary school-children in Port Harcourt, Nigeria. Paediatrics and International Child health. 2012; 32(4):208-212.
• [23]Steyn NP, McHiza ZJ. Obesity and the nutrition transition in Sub-Saharan Africa. Ann N Y Acad Sci. 2014; 1311:88-101.
• [24]Lo JC, Sinaiko A, Chandra M, Daley MF, Greenspan LC, Parker ED, Kharbanda EO, Margolis KL, Adams K, Prineas R et al.. Prehypertension and hypertension in community-based pediatric practice. Pediatrics. 2013; 131(2):e415-424.
• [25]Acosta AA, Samuels JA, Portman RJ, Redwine KM. Prevalence of persistent prehypertension in adolescents. J Pediatr. 2012; 160(5):757-761.
• [26]Bao W, Threefoot SA, Srinivasan SR, Berenson GS. Essential hypertension predicted by tracking of elevated blood pressure from childhood to adulthood: the Bogalusa Heart Study. Am J Hypertens. 1995; 8(7):657-665.
• [27]Suh I, Webber LS, Cutler JA, Berenson GS. Relationship of change in body mass to blood pressure among children in Korea and black and white children in the United States. Yonsei Med J. 1995; 36(5):402-411.
• [28]Toschke AM, Kohl L, Mansmann U, von Kries R. Meta-analysis of blood pressure tracking from childhood to adulthood and implications for the design of intervention trials. Acta Paediatr. 2010; 99(1):24-29.
• [29]Woelk G. Blood pressure tracking from child to adulthood: a review. Cent Afr J Med. 1994; 40(6):163-169.
• [30]Clarke WR, Schrott HG, Leaverton PE, Connor WE, Lauer RM. Tracking of blood lipids and blood pressures in school age children: the Muscatine study. Circulation. 1978; 58(4):626-634.
• [31]Yong LC, Kuller LH. Tracking of blood pressure from adolescence to middle age: the Dormont High School Study. Prev Med. 1994; 23(4):418-426.
• [32]Kollias A, Pantsiotou K, Karpettas N, Roussias L, Stergiou GS. Tracking of blood pressure from childhood to adolescence in a Greek cohort. Eur J Public Health. 2012; 22(3):389-393.
• [33]Lauer RM, Anderson AR, Beaglehole R, Burns TL. Factors related to tracking of blood pressure in children. U.S. National Center for Health Statistics Health Examination Surveys Cycles II and III. Hypertension. 1984; 6(3):307-314.
• [34]Miersch A, Vogel M, Gausche R, Siekmeyer W, Pfaffle R, Dittrich K, Kiess W. Blood pressure tracking in children and adolescents. Pediatr Nephrol. 2013; 28(12):2351-2359.
• [35]Falkner B, Gidding SS, Portman R, Rosner B. Blood pressure variability and classification of prehypertension and hypertension in adolescence. Pediatrics. 2008; 122(2):238-242.
• [36]Sun SS, Grave GD, Siervogel RM, Pickoff AA, Arslanian SS, Daniels SR. Systolic blood pressure in childhood predicts hypertension and metabolic syndrome later in life. Pediatrics. 2007; 119(2):237-246.
• [37]Redwine KM, Acosta AA, Poffenbarger T, Portman RJ, Samuels J. Development of hypertension in adolescents with pre-hypertension. J Pediatr. 2012; 160(1):98-103.
• [38]Dasgupta K, O’Loughlin J, Chen S, Karp I, Paradis G, Tremblay J, Hamet P, Pilote L. Emergence of sex differences in prevalence of high systolic blood pressure: analysis of a longitudinal adolescent cohort. Circulation. 2006; 114(24):2663-2670.
• [39]Park MK, Menard SM. Accuracy of blood pressure measurement by the Dinamap monitor in infants and children. Pediatrics. 1987; 79(6):907-914.