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Obesity and season as determinants of high blood pressure in a school-based screening study

Journal of Human Hypertension (2019) | Download Citation


This school-based screening study assessed the prevalence of high blood pressure (BP) levels according to the European Society of Hypertension (ESH) 2016 guidelines. Moreover, risk factors for BP elevation, and the effect of geographic and seasonal factors on BP screening were investigated. BP and anthropometric measurements were obtained from 2832 children and adolescents, aged 6–18 years, during the period 2013–2016. Three BP measurements were performed using a mercury sphygmomanometer, and the mean of the last two was used for the analysis. Obesity was defined according to the International Obesity Task Force (IOTF) criteria. The prevalence of high–normal BP/hypertension and overweight/obesity was 3.7%/0.9%, and 22.9%/8.5%, respectively. The majority of the participants presenting high BP (≥90th percentile) were overweight or obese. Increased prevalence of high BP was observed during spring (5.5%) and winter (5%) compared with 2.5% in autumn (P<0.05). SBP z scores were higher in males, during spring and summer, and in urban areas. In conclusion, a low rate of high–normal and hypertensive BP levels was found despite the high prevalence of overweight and obesity. Overweight and obesity were associated with higher BP levels, but there was also a seasonal difference in the prevalence of high BP levels.

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The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.

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Authors’ contributions

TN: performed data collection, drafted the initial paper, revised and approved the final version; SS: analyzed the data, edited, revised, and approved the final version; KP and NP: edited, revised, and approved the final version; CA: analyzed the data; KK and FP: supervised the study, revised, and approved the final draft; VK: designed the study, edited, revised, and approved the final version.

Author information


  1. 3rdDepartment of Pediatrics, Aristotle University of Thessaloniki, Hippokratio Hospital, Thessaloniki, Greece

    • Thomaitsa Nika
    •  & Konstantinos Kollios
  2. 1stDepartment of Pediatrics, Aristotle University of Thessaloniki, Hippokratio Hospital, Thessaloniki, Greece

    • Stella Stabouli
    • , Nikoleta Printza
    •  & Fotios Papachristou
  3. 4thDepartment of Pediatrics, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece

    • Kyriaki Papadopoulou-Legbelou
  4. 3rdDepartment of Internal Medicine, Aristotle University of Thessaloniki, Hypertension-24h ABPM Center, Papageorgiou General Hospital, Thessaloniki, Greece

    • Christina Antza
    •  & Vasilios Kotsis


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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures in the study werein accordance with the ethical standards of the Greek Ministry of National Education, the National Educational Institute and the Ethics Committee of Aristotle University of Thessaloniki, which approved the study protocol (65104/Γ7/15–05–2013).

Informed consent

Informed consent was obtained from all individual participants included in the study and their parents or legal guardians.

Corresponding author

Correspondence to Thomaitsa Nika.

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