Prevalence and predictors of pediatric high blood pressure: an Egyptian school-based survey

Abstract

Abstract Background Childhood hypertension (HTN) is a substantial public health problem due to its rising trend and strong correlation with adulthood HTN with its long-term sequelae. It has notable unmodifiable and modifiable risk factors. The current study aimed to estimate the prevalence of high blood pressure (BP); (elevated BP and HTN), among preparatory schoolchildren in El-Beheira Governorate, Egypt and to identify correlates associated with high BP. Methods Using a multistage random sampling, from El Beheira governorate 15 districts, Damanhur was chosen where 4 preparatory schools (two for boys + two for girls) and 856 students aged 11–14 years were recruited for a cross-sectional study. A pre-designed structured interview questionnaire having socio-demographic information; habitual and family history data; besides anthropometric and three BP measurements were obtained for each student. BP was classified according to the new American normative BP in healthy children and adolescents. Results Students boys and girls were equally distributed (50%), with an average age of 13.3 ± 0.66 years. Among the students, 27% were obese/overweight and 40% didn’t exercise regularly. The frequency of elevated BP and HTN was 9.1% and 6.9%, respectively. High BP predominated with girls (crude odds ratio (COR) = 2.811, 95% confidence interval (CI); 1.891–4.178), physical inactivity (≤ once weekly: COR = 30.366, 95% CI; 15.424–59.785, & 2–3 times weekly: COR = 19.364, 95% CI; 10.253–36.571), high risk diet (COR = 4.302, 95% CI; 2.944–6.289), added table salt (COR = 13.374, 95% CI; 8.037–22.257), family history of HTN (COR = 2.003, 95% CI; 1.330–3.018), overweight (COR = 3.718, 95% CI; 2.243–6.161), obesity (COR = 8.444, 95% CI; 5.322–13.399), and abdominal obesity (COR = 4.016, CI; 2.744–5.877), (p < 0.05). The multivariate analysis revealed that physically activity ≤ once weekly (adjusted odds ratio (AOR) = 15.679, 95% CI; 6.936–35.443) & 2–3 times weekly physical activity (AOR = 10.738, 95% CI; 5.247–21.973), usage of added table salt (AOR = 5.745, 95% CI; 3.108–10.617), being overweight (AOR = 2.735, 95% CI; 1.298–5.765) and obese (AOR = 7.463, 95% CI; 3.414–16.314) were the predictors for having high BP level among the students, (p < 0.05). Conclusions Screening of schoolchildren has explicitly unveiled the high frequency of high BP (elevated BP and HTN) among preparatory schoolchildren tipped the scales in favor of the importance of applying preventive strategies that emphasize screening and early detection of childhood elevated BP and HTN and conducting longitudinal prospective studies to establish causality of the identified associated factors.