Abstract
Despite complex presentation of adult hypertension and a concomitant obesity epidemic, little is known about overweight in relation to blood pressure among Caribbean children. We examined blood pressure in relation to body size in a cross-sectional study of 573 Barbadian children aged 9–10 years (2010-2011).The United States normative blood pressure percentiles were used to identify children with high (≥ 95th percentile) or high normal blood pressure (90th – 95th percentile). The World Health Organization body mass index cut-off points were used to assess weight status.Major findingsThirty percent of children were overweight/obese. Percentage fat mass differed between girls (20.4%) and boys (17.72%) (p< 0.05). Mean systolic blood pressure among girls was 106.11 (95% CI 105.05, 107.17) mmHg and 105.23 (104.09, 106.38) for boys. The percentages with high or high-normal mean systolic blood pressurewere14.38% (10.47, 18.29) for girls and 8.08% (4.74, 11.41) for boys. Height and body mass index were independent correlates of systolic and diastolic blood pressure. Mean systolic blood pressure was related to lean mass but not fat mass, while diastolic blood pressure was associated with fat mass index and overweight.Principal conclusionOne third of 9-10 year old children in Barbados were overweight/obese and 12% had elevated mean systolic blood pressure. BP was related to body size. These findings signal potential adverse trends in weight gain and BP trends for children growing up in the context of a country that has recently undergone rapid economic transition.
Highlights
Hypertension (HTN) is a major public health burden in the Caribbean, closely related to overweight and the level of economic development.[1]
Family circumstances may modify the relationship between weight status and blood pressure via socio-economic disadvantage.[9]
This estimate is based on a prevalence of 27% overweight using the International Obesity Task Force (IOTF) BMI cut-off points among Barbadian children 10–16 years in 1999 [13] and 26% overweight among children aged 15–18 years from southern Brazil in 2001–2002.[14]. Given that the prevalence of overweight generally increases with age, we expected the prevalence among children aged 9–10 years in Barbados to be slightly lower than that of older children, due to a worldwide trend of secular increases.[15]
Summary
Hypertension (HTN) is a major public health burden in the Caribbean, closely related to overweight and the level of economic development.[1] Periera’s review (2009) of prevalence of hypertension in developed and developing countries showed that the prevalence in Barbados was higher than other countries in the Caribbean and Latin American region, Africa and most of Europe, and was highest in the world for women.[2] Hypertension is a risk factor for stroke, coronary heart disease, heart failure and chronic renal failure and its global importance is recognized, in the context of increasing obesity. Studies of overweight and of BP in Caribbean children are of both aetiological and clinical significance
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