Systemic hypertension and associated factors in school adolescents

Background: Systemic hypertension is an endemic disease, which causes serious morbidities and mortality in all age groups. Hypertension of adults in Egypt is 26%. It can start in childhood and needs to be assessed in Egyptian children and adolescents.

Aim and objectives: This study aims to investigate the prevalence of systemic hypertension in 12-14 year old school children and associated factors.

Methods and study design: A cross sectional study was done in some preparatory public and private schools selected from a district of Cairo. The 234 children (167 females, 67males) in this study were 12 - 14 year of age. Their weight ranged from 30 – 100 kg Subjects with high blood pressure (BP) were identified according to the percentiles of Rosner, et al. Beside characteristics of the sample and blood pressure (BP), associated factors investigated were: - weight and body mass index (BMI), tea / coffee consumption, "added salt before tasting food", sleeping less than 8 hours per day and physical activity. Each student filled out stress and tension level tests. The school health team obtained informed parental consent to include their children in this study. Statistical analysis was done with EPI using chi-square, ttest, odd ratio (OR) with 95% confidence limits (Cl) and logistic regression with the 5% level for tests. The ethical committee of the faculty approved the study.

Results / Finding: The prevalence of systemic hypertension was 10%. Children with high BP (23) were compared to 211 subjects with normotensive BP. High stress and tension score, less sleeping hours / day, adding salt to food and higher BMI were found significantly associated (p<0.05) with high BP. Study limitation: Researchers could assess preparatory schools children. However, primary and secondary school levels are separated in other schools and administrations. We used US standards for hypertension and BMI for children as local standards are not published.

Conclusions: One tenth of 12-14 year old school adolescents in this study have systemic hypertension. The main associated factors are obesity, overuse of salt and less sleeping hours. A larger study is needed to assess the prevalence of hypertension in all ages of school children. A population-based case-control study is recommended for the future. School physicians and pediatricians need to measure routinely blood pressure of children to prevent hypertension.

Author(s): Salma B. Galal , Soheir A. Fahmy , Somia Lashine , ahed Abdel-Fattah , Mohammed Omar Galal

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