Abstract
BackgroundChildhood hypertension is a predictor of later diseases, increases the risk for cardiovascular morbidity and mortality in adulthood and results in major economic burdens.The purpose of this study was to investigate the direct and indirect effect of anthropometric, socioeconomic and lifestyle factors on blood pressure (BP) in a large population-based sample of children and adolescents using a path analysis.MethodsThis multi-centric nationwide study was performed on students aged 7–18 years. Anthropometric indices and blood pressure were measured by standard methods and demographic data, socioeconomic status, dietary habits and health related behaviors were obtained using validated questionnaires. Path analysis was applied to evaluate the relationships among the study variables and to implement the subsequent structural modeling.ResultsTotally, 7235 students (50.6% boys; the mean age 12.3 ± 3.1 years) were assessed. Systolic and diastolic BP positively correlated with age (r = 0.35 and 0.26; respectively), BMI (r = 0.06 and 0.04; respectively) and WC (r = 0.05 and 0.03; respectively). According to path analysis, age had significant direct effect on BMI, WC, and BP (β = 0.035, 0.043 and 0.345; respectively), which was greater for BP. BMI and WC had the greatest direct effect on BP (β = 0.05 and 0.03; respectively). Education level, subjective health complaints, health-related behaviors and dietary habits had positive direct effects on BP (β = 0.036, 0.030, 0.018 and 0.017; respectively). Socioeconomic status and positive changes in diet had negative indirect effect on BP (β = − 0.001 for both).ConclusionOur findings strengthen the importance of weight and body composition in BP control. It is suggested to improve diet and health related behaviors especially in families with low socioeconomic position.
Highlights
Childhood hypertension is a predictor of later diseases, increases the risk for cardiovascular morbidity and mortality in adulthood and results in major economic burdens
No significant correlations observed between blood pressure and socio economic status (SES), Subjective health complaints (SHC) and health-related behaviors (HRB)
Age had significant direct effect on all three outcome variables (BMI, Waist circumference (WC), and blood pressure (BP)), which was greater for BP
Summary
Childhood hypertension is a predictor of later diseases, increases the risk for cardiovascular morbidity and mortality in adulthood and results in major economic burdens. High blood pressure that originates early in life is a predictor of later diseases, increases the risk for cardiovascular morbidity and mortality in adulthood and results in major economic burdens [1, 2]. The prevalence of hypertension was reported 6.82% among Iranian school children by considering the additive prevalence of pre hypertension and hypertension; isolated high systolic and diastolic blood pressure was documented in 4.17 and 4.33%, respectively [5]. Both genetic and environmental factors play roles in pathology of hypertension in children and adolescents [6]. Paying more attention to the factors associated with childhood hypertension would be helpful for primary prevention of its complications in adulthood
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