Trends and Status of the Prevalence of Elevated Blood Pressure in Children and Adolescents in China: a Systematic Review and Meta-analysis.

Abstract

To evaluate the status of elevated blood pressure in Chinese children and adolescents, and identify potential influence factors. We searched PubMed, the Web of science, the WanFang, the VIP, and the CNKI to identify articles that were published from Jan 1, 1997, to May 30, 2019. We used random effects models to estimate the pooled prevalence of elevated blood pressure, and heterogeneity among the studies was assessed with Cochran's Q statistic. The potential source of heterogeneity was explored by meta-regression and subgroup comparisons using Q test based on ANOVA. Fifty-nine studies were included in the qualitative synthesis and the prevalence of elevated blood pressure ranged from 2.2 to 26.4%. The meta-analysis included 25 studies (341,281 participants), and the pooled prevalence of elevated blood pressure was 9.8% (95% CI 7.9, 11.9). The prevalence of elevated blood pressure in the obese children (34.1%, 95% CI 26.9, 41.7) and overweight children (15.5%, 95% CI 10.1, 21.7) was much higher than that in the normal or underweight children (5.0%, 95% CI 2.4, 8.4). Fluctuating trends in the prevalence of elevated blood pressure both in the total sample of Chinese children and adolescents and in each subgroup were observed from 2007 to 2014. Our study showed that prevalence of elevated blood pressure in children and adolescents in China was in the medium level in the world. Primary prevention for childhood hypertension should be implemented and focus on weight control and healthy lifestyle habits.