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The risk factors for elevated blood pressure and how to address cardiovascular risk factors: a review in paediatric populations

Abstract

This paper examines the epidemiology of hypertension and management strategies of cardiovascular diseases (CVDs) in paediatric populations in sub-Saharan Africa and other parts of the world in the 21st century. A computerized literature search was carried out using Medline, Evidence-Based Child Health (A Cochrane Review Journal), the Cochrane Library and Cochrane Child Health Field. A manual search in the African Journal for physical, health education, recreation and dance, the South African Journal for Research in Sports, Physical Education and Recreation and a few individuals in the area were requested to send some of their recent unpublished and published reports in the field. High prevalence rates and high odds ratios for high blood pressure (BP) were recorded in children aged 5–17 years. There is a need for health ministries to improve the public health sector so as to close the gap between the rich and the poor. Although personal and parental responsibility remain crucial, it also falls on the government to help control powerful environmental factors that are leading our children to premature ill-health and mortality. Equally, health professionals are increasingly recognized that they have a significant role to play in delivering medical treatment of hypertension in children.

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References

  1. Spear BA . Adolescence growth and development. J Am Diet Assoc 2002; 102: S23–S29.

    Article  PubMed  Google Scholar 

  2. Cameron N . African obesity: a puzzle solved. SAMJ 1997; 87: 1396–1397.

    CAS  PubMed  Google Scholar 

  3. Heald FP . Adolescence Nutrition. Med Clin North Am 1975; 59: 1329–1336.

    Article  CAS  PubMed  Google Scholar 

  4. Bojorntor P . Regional obesity. In: Bjortorp P, Brodoff BN (eds). Obesity. Lippincot: Philladelphia, 1992, pp 579–586.

    Google Scholar 

  5. Schmieder RE, Messerli FH, Ruddel H . Risk for arterial hypertension. Clin Cardiol 1986; 4: 57–66.

    Article  CAS  Google Scholar 

  6. Watkins LO . Epidemiology and burden of cardiovascular disease. Clin Cardiol 2004; 27: III-2.

    Article  Google Scholar 

  7. Arias E, Anderson RN, Hsiang-Ching K, Murphy SL, Kochanek KD . Death: Final data for 2001, National Vital Statistics Report, 52 No 3. National Centre for Health Statistics: Hyattsville Maryland, 2003, pp 27–87.

    Google Scholar 

  8. Bradshaw D, Steyn K . Poverty and chronic disease in South Africa: Technical Report. Medical Research Council: Cape Town, 2001, pp 17–68.

    Google Scholar 

  9. Arthington AH, Bunn SE, Poff NL, Naiman RJ . The challenge of providing environmental flow rules to sudden river ecosystems. Ecol Appl 2006; 16: 1311–1318.

    Article  PubMed  Google Scholar 

  10. World Health Organization. WHO guidelines on agricultural practices (GACP) for medicinal plants. World Health Organization: Geneva, Switzerland, 2003, pp 2–57.

  11. Barba G, Troiano E, Russo P, Strazzullo P, Siani A . On behalf of ARCA Project Study Group. Body mass, fat distribution and blood pressure in Southern Italian children: Results of ARCA project. Nutr Meta Cardiovas Dis 2006; 16: 239–248.

    Article  Google Scholar 

  12. Makgae PJ, Monyeki KD, Brits JS, Kemper HCG, Mashita J . Somatotype and blood pressure of rural South African children aged 6–13 years: Ellisras Longitudinal Growth and Health Study. Ann Hum Biol 2007; 34: 240–251.

    Article  CAS  PubMed  Google Scholar 

  13. Addo J, Amoah AGB, Koram K . The changing patterns of hypertension in Ghana: A study of four rural communities in the GA district. Ethn Dis 2006; 16: 895–900.

    Google Scholar 

  14. Smith C, Rinderknecht K . Obesity correlates with increase blood pressures in Urban Native American youth. Am J Hum Biol 2003; 15: 78–90.

    Article  PubMed  Google Scholar 

  15. National high blood pressure education program (NHBPEP) working group on hypertension control in children and adolescents. Update on the 1987 task force report on high blood pressure in children and adolescents: a working group report from the National High Blood Pressure Education Program. Pediatrics 1996; 98: 649–658.

    Google Scholar 

  16. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 2004; 114: 555–576.

    Article  Google Scholar 

  17. Schmieder RE, Messerli FH . Environmental factors as a risk for future hypertension. Stress Med 2006; 2: 241–251.

    Article  Google Scholar 

  18. Van Lenthe FJ, Kemper HCG, Twisk JWR . Tracking blood pressure in children and youth. Am J Hum Biol 1994; 6: 389–399.

    Article  PubMed  Google Scholar 

  19. Misra A, Madhavan M, Vikram NK, Pamdey RM, Dhingra V, Luthra K . Simple anthropometric measures identify fasting hyperinsulinemia and clustering of cardiovascular risk factors in Asian Indian adolescents. Metab Clin Ex 2006; 55: 1569–1573.

    Article  CAS  Google Scholar 

  20. Yusuf S, Reddy S, Ounapuu S, Anands S . Global burden of Cardiovascular Disease. Part I: General consideration, the epidemiological transition, risk factors and impact of urbanization. Circulation 2001; 104: 2746–2753.

    Article  CAS  PubMed  Google Scholar 

  21. Al-Sendi AM, Shetty P, Musaiger AO, Myatt M . Relationship between body composition and blood pressure in Bahraini adolescence. Br J Nutr 2003; 90: 837–844.

    Article  CAS  PubMed  Google Scholar 

  22. World Health Organization. WHO Expert Committee on Hypertension control. World Health Organization: Geneva, Switzerland, 1994. www.who.int/acd/avd/trs862.html#table.

  23. Van der Sande MAB, Milligan PJM, Walraven GEL, Dolmans WMV, Newport M, Nyan OA et al. Geographical variation in prevalence of hypertension with the Ghambia. J Hum Hypertens 2001; 15: 733–739.

    Article  CAS  PubMed  Google Scholar 

  24. Frontini MG, Srinivasan SR, Elkasabany A, Berenson G . Awareness of hypertension and dyslipidemia in a semi rural population of young adults: the Bangalusa Heart Study. Prev Med 2003; 36: 398–402.

    Article  PubMed  Google Scholar 

  25. Barger SD, Muldoon MF . Hypertension labeling was associated with poorer self-rate health in the Third US National Health and Nutrition Examination Survey. J Hum Hypertens 2006; 20: 117–123.

    Article  CAS  PubMed  Google Scholar 

  26. Monyeki KD, Kemper HCG, Twisk JWR, Makgae PJ, Mashita J, Travill A . Longitudinal development and tracking of risk indicators for cardiovascular diseases of rural South African children: Ellisras Longitudinal Growth and Health Study. J Sci 2007 (in press).

  27. Facchini F, Fiori G, Bedogni G, Galletti L, Belcastro MB, Ismagulov O et al. Prevalence of overweight and cardiovascular risk factors in rural and urban children from central Asia: The Kazakhstan Health and Nutritional Examination Survey. Am J Hum Biol 2007; 19: 809–820, 10.102/ajbh.

    Article  PubMed  Google Scholar 

  28. Israel E, Korzets Z, Tekes-Manova D, Tirosh A, Schochat T, Bernheim J et al. Blood Pressure categories in Adolescence Predict Development of hypertension in accordance with European guidelines. AJH 2007; 20: 705–709.

    Google Scholar 

  29. Maffeis C, Pietrobelli A, Grezzani A, Provera S, Tato L . Waist circumference and Cardiovascular risk factors in pre pubertal children. Obes Res 2001; 9: 179–187.

    Article  CAS  PubMed  Google Scholar 

  30. Steyn K, de Wet T, Richter L, Cameron N, Levitt NS, Morrel C . Cardiovascular diseases risk factors in 5-year old urban South African children- The Birth to Ten Study. SAMJ 2000; 90: 719–726.

    CAS  PubMed  Google Scholar 

  31. Schutte AE, van Rooyen JM, Huisman HW, Kruger HS, Malan NT . The potential role of biotin as dietary risk marker for hypertension in black South African children- the THUSA BANA study. SAJCN 2003; 16: 144–148.

    Google Scholar 

  32. Schutte AE, van Rooyen JM, Huisman HW, Kruger HS, de Ridder JH . Factor analysis of possible risk for hypertension in a black South African population. J Hum Hypertens 2003; 17: 339–348.

    Article  CAS  PubMed  Google Scholar 

  33. Monyeki KD, Kemper HCG, 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: 114–120.

    Article  CAS  PubMed  Google Scholar 

  34. Moore WE, Stephens A, Wilson T, Wilson W, Eichner JE . Body mass index and blood pressure screening in a rural public school system: the Health Kids Projects. Prev Chr Dis Pub Healt R, Pract and Policy 2006; 3: 1–10.

    Google Scholar 

  35. Agirbasli M, Tanrikulu B, Arikan S, Izci E, Ozguven S, Besimoglu B et al. Trends in body mass index, blood pressure and parental smoking habits in middle socio-economic level Turkish adolescents. J Hum Hypertens 2007; 22: 1–6.

    Google Scholar 

  36. O'Connor PJ . Overcome clinical linarite to control systolic blood pressure. Arch Intern Med 2003; 163: 2677–2678.

    Article  PubMed  Google Scholar 

  37. Jones MA, Schlenk EA, Kitutu JM, Sereika SM, Doswell WM, Dunbar-Jacob J . Ethnic differences in the adherence to antihypertensive medications: A prospective study (abstract). Circulation 2003; 108: IV-381.

    Google Scholar 

  38. Ben-Shlomo Y, Kuh D . A life course approach to chronic diseases epidemiology: conceptual models, empirical challenges and interdisciplinary perspectives. Int J Epidemiol 2002; 31: 285–293.

    Article  PubMed  Google Scholar 

  39. Kaplan NM . Hypertension: Prevalence, risks and effect of therapy. Ann Intern Med 1983; 98: 705–709.

    Article  CAS  PubMed  Google Scholar 

  40. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo Jr JL et al. Joint national committee on prevention detection evaluation and treatment of high blood pressure: National Heart, lung and blood Institute: National High Blood Pressure program Coordinating Committee, Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension 2003; 42: 1206–1252.

    Article  CAS  PubMed  Google Scholar 

  41. Lewington S, Clarke R, Qizilbash N, Peto R, Collins R . Age specific relevance of usual blood pressure to vascular mortality: a meta analysis of individual data for one million adults in 61 prospective studies. Lancet 2002; 360: 1903–1913.

    Article  PubMed  Google Scholar 

  42. Washington R . Intervention to reduce cardiovascular risk factors in children and adolescents. Am Fam Physician 1999; 59: 2211–2219.

    CAS  PubMed  Google Scholar 

  43. Williams B, Poulter NR, Brown MJ, McInnes GT, Potter JF, Sever PS et al. Education and debate. British hypertension Society guidelines for hypertension management 2004 (BHS-IV): Summary. BMJ 2004; 328: 634–640.

    Article  PubMed Central  PubMed  Google Scholar 

  44. Lemogoum D, Seedat YK, Mabadeje FB, Mendis S, Bovet P, Onwubere B et al. Recommendation for prevention, diagnosis and management of hypertension and cardiovascular risk factors in Sub-Saharan Africa. J Hypertens 2003; 21: 1993–2000.

    Article  CAS  PubMed  Google Scholar 

  45. Rosner B, Cook NR, Evan DA, Keough ME, Taylor JO, Polk BF et al. Reproducibility and predictive values of routine blood pressure measurements in children. Comparison with adult values and implications for screening children for elevated blood pressure. Am J Epidemiol 1987; 126: 1115–1125.

    Article  CAS  PubMed  Google Scholar 

  46. Kemper HCG, Snel J, Verschuur R, Storm van Essen L . Tracking of health and risk indicators of cardiovascular diseases from teenager to adulthood: The Amsterdam Growth and Health Study. Prev Med 1991; 19: 642–655.

    Article  Google Scholar 

  47. Zinner SH, Martins LF, Sacks F, Rosner B, Kass EH . A longitudinal study of blood pressure in childhood. Am J Epidemiol 1974; 100: 437–442.

    Article  CAS  PubMed  Google Scholar 

  48. Shasha SM, Cohe-Tal I, Epstein L, Tamir A . Tracking of blood pressure in children: results of 7 years follow-up. The Nahariya Study. Isr J Med Sci 1988; 24: 671–675.

    CAS  PubMed  Google Scholar 

  49. Weir MR, Stafford EM, Gregory G, Lawson MA, Peal W . The relationship between sexual maturity rating, age and increased blood pressure in adolescent. J Adoles Health Care 1988; 9: 465–469.

    Article  CAS  Google Scholar 

  50. Voors AW, Webber LS, Berenson GS . Time course study of blood pressure in children over a three-year period. Bagalusa Heart Study. Hypertension 1980; 2: 102–108.

    Article  CAS  PubMed  Google Scholar 

  51. Katz SH, Hediger ML, Schall JI, Bowers EJ, Barker WF . Blood pressure, growth and maturation from childhood through adolescent. Hypertension 1980; 2: I-55–I-69.

    Article  Google Scholar 

  52. Kuh DJL, Ben Schlomo Y . A life course approach to chronic disease epidemiology. Oxford University press: Oxford, 2004, pp 23–72.

    Book  Google Scholar 

  53. Chen W, Srinivasan SR, Li S, Xu J, Berenson GS . Metabolic syndrome variables at low levels in childhood are beneficial associated with adulthood cardiovascular risk: the Bangalusa heart study. Diabetes Care 2005; 1: 125–126.

    Google Scholar 

  54. Berenson GS, Srnivasan SR . Cardiovascular risk factor in youth with implications for aging: the Bogalusa Heart Study. Neurobiol Aging 2005; 26: 303–307.

    Article  CAS  PubMed  Google Scholar 

  55. Kemper HCG . Amsterdam growth and Health longitudinal study: A 23 year follow up from teenager to adult about lifestyle and health. Karger: New York, 2004, pp 1–20.

    Google Scholar 

  56. Graudal NA, Galloe AM, Garred P . Effects of sodium restriction on blood pressure, rennin, adolescent, catecholamine's, cholesterols and triglyceride: a meta analysis. JAMA 1998; 279: 1383–1391.

    Article  CAS  PubMed  Google Scholar 

  57. Ryden L, Stokoe G, Breithardt G, Lindemans F, Potgieters A . Patience access to Medical technology across Europe. Eur Heart J 2004; 25: 611–616.

    Article  PubMed  Google Scholar 

  58. Republic of South Africa Tobacco Board. Annual Report. Government Printer: Pretoria, 1998, pp 119–130.

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Acknowledgements

Dr Taryn Young, Cochrane Library, Medical Research Council is thankfully acknowledged for the advice and valuable information she provided in the preparation of this manuscript. The authors are grateful to Tania Witbooi, Chronic Diseases of Lifestyle Unit, Medical Research Council and Titus Motlogeloa, Johanna Makgae and Thomas Makata, Ellisras Longitudinal Growth and Health Study administrators and to the South African Medical Research Council for providing technical support in the preparation of this manuscript. Monyeki MS and Malatji MJ (Makgoka High School, Limpopo Province) are thankfully acknowledged for editing this manuscript.

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Monyeki, K., Kemper, H. The risk factors for elevated blood pressure and how to address cardiovascular risk factors: a review in paediatric populations. J Hum Hypertens 22, 450–459 (2008). https://doi.org/10.1038/jhh.2008.21

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Keywords

  • cardiovascular diseases
  • children
  • sub-Saharan Africa

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