Prevalence Of Hypertension In Children Research Articles

Prevalence of childhood hypertension and associated factors in Zhejiang Province: a cross-sectional analysis based on random forest model and logistic regression

With childhood hypertension emerging as a global public health concern, understanding its associated factors is crucial. This study investigated the prevalence and associated factors of hypertension among Chinese children. This cross-sectional investigation was conducted in Pinghu, Zhejiang province, involving 2,373 children aged 8–14 years from 12 schools. Anthropometric measurements were taken by trained staff. Blood pressure (BP) was measured in three separate occasions, with an interval of at least two weeks. Childhood hypertension was defined as systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) ≥ age-, sex-, and height-specific 95th percentile, across all three visits. A self-administered questionnaire was utilized to collect demographic, socioeconomic, health behavioral, and parental information at the first visit of BP measurement. Random forest (RF) and multivariable logistic regression model were used collectively to identify associated factors. Additionally, population attributable fractions (PAFs) were calculated. The prevalence of childhood hypertension was 5.0% (95% confidence interval [CI]: 4.1–5.9%). Children with body mass index (BMI) ≥ 85th percentile were grouped into abnormal weight, and those with waist circumference (WC) > 90th percentile were sorted into central obesity. Normal weight with central obesity (NWCO, adjusted odds ratio [aOR] = 5.04, 95% CI: 1.96–12.98), abnormal weight with no central obesity (AWNCO, aOR = 4.60, 95% CI: 2.57–8.21), and abnormal weight with central obesity (AWCO, aOR = 9.94, 95% CI: 6.06–16.32) were associated with an increased risk of childhood hypertension. Childhood hypertension was attributable to AWCO mostly (PAF: 0.64, 95% CI: 0.50–0.75), followed by AWNCO (PAF: 0.34, 95% CI: 0.19–0.51), and NWCO (PAF: 0.13, 95% CI: 0.03–0.30). Our results indicated that obesity phenotype is associated with childhood hypertension, and the role of weight management could serve as potential target for intervention.

Epidemiological and Cardiovascular Prognostic Profile of Pediatric Arterial Hypertension at the Hospital National Ignace Deen de Conakry (Guinea)

<i>Introduction</i>: The prevalence of hypertension in children is much lower, around 1 to 5%. Clinical signs are still marked by accidents revealing neurological, cardiac and renal damage. The aim was to determine the epidemiological profile and prognosis of pediatric hypertension at the Ignace Deen National Hospital. Materials and methods: This was a prospective descriptive study of children and adolescents admitted to the pediatric ward of the Ignace Deen National Hospital during the period March 1 to August 31, 2021. All those aged 1 to 15 years declared hypertensive with mean systolic or diastolic blood pressure ≥ 95th percentile were included in this study. <i>Results</i>: Out of a total of 464 patients, our study included 12 cases, representing a 2.52% incidence of arterial hypertension; the mean age of our patients was 8 years ±2 years; males predominated, with a sex ratio equal to 2; physical signs were marked by edema of the lower limbs (66.67%); Immediately threatening hypertension represented 41.67%; hypertensive retinopathy was found in 33.33% of patients; 16.67% of patients presented with LVH; 25%; renal complications were 25%; mortality was of the same order 25%. <i>Conclusion</i>: The complications of pediatric hypertension are a real public health problem, with a high morbidity and mortality rate.

The Role of Subcutaneous Fat Composition on Blood Pressure: A Study on Students Aged 15-18 at Kalam Kudus II Senior High School Jakarta, Indonesia

Background: Hypertension is one of the leading causes of death worldwide. There was an increase in the prevalence of hypertension in children and adolescents ≤19 years of age from 2000 to 2015. Body mass index (BMI) and subcutaneous fat distribution are linked to blood pressure variations. Methods: The cross-sectional study was carried out at Kalam Kudus II Senior High School Jakarta from June – August 2023. The inclusion criteria in this study included students of Kalam Kudus II Senior High School Jakarta, aged 15-18 years, registered as active students at the time the study was conducted, physically and spiritually healthy, and willing to participate in the study. The exclusion criteria for this study include students who refused participation, did not obtain permission from their parents, or students with medical disorders that affect anthropometric results and blood pressure. Data was taken from direct measurement and performed multivariate testing using the double linear regression test enter method in SPSS. The statistical significance is 0.05. Results: An analysis of 102 students found that only BMI had a significant relationship with systolic blood pressure, and no anthropometric variable had a meaningful relationship with diastolic pressure. Conclusion: There are many ways and factors for measuring body composition. It is important to test the body composition and BMI of adolescents to reduce the risk of hypertension later in the day.

The ongoing impact of obesity on childhood hypertension.

Obesity rates among children have been steadily rising over the past several decades. This epidemic has been accompanied by an increase in the prevalence of childhood hypertension, with children in low- and middle-income countries being affected to the same extent as children in high-income countries. This review will examine the trends in childhood blood pressure and the relationship between excess body weight and the development of hypertension. In addition, distinct mechanisms of obesity-related hypertension will be discussed. There will be an emphasis on recent studies conducted since the publication of new guidelines by the American Academy of Pediatrics in 2017 which resulted in the adoption of lower normative blood pressure cutoffs. The overall intent of this review is to provide the reader with an understanding of the ongoing impact, and complexities, of obesity-related hypertension.

Source apportionment of heavy metals in PM2.5 samples and effects of heavy metals on hypertension among schoolchildren in Tianjin.

The prevalence of hypertension in children has increased significantly in recent years in China. The aim of this study was to provide scientific support to control ambient heavy metals (HMs) pollution and prevent childhood hypertension.In this study, ambient HMs in PM2.5 were collected, and 1339 students from Tianjin were randomly selected. Positive matrix factorization (PMF) wasused to identify and determine the sources of HMspollution. The generalized linear model, Bayesian kernel machine regression (BKMR) and the quantile g-computation method were used to analyze the relationships between exposure to HMsand the risk of childhood hypertension. The results showed that HMs in PM2.5 mainly came from four sources: soil dust, coal combustion, incineration of municipal wasteand the metallurgical industry. The positive relationships between As, Se and Pb exposures and childhood hypertension risk were found. Coal combustion and incineration of municipal waste were important sources of HMs in the occurrence of childhood hypertension.Based on these accomplishments, this study could provide guidelines for the government and individuals to alleviate the damaging effects of HMs in PM2.5. The government must implement policies to control prime sources of HMs pollution.

Pediatric Primary Hypertension: An Underrecognized Condition: A Scientific Statement From the American Heart Association.

The overall prevalence of hypertension in childhood is 2% to 5%, and the leading type of childhood hypertension is primary hypertension, especially in adolescence. As in adults, the leading risk factors for children with primary hypertension are excess adiposity and suboptimal lifestyles; however, environmental stress, low birth weight, and genetic factors may also be important. Hypertensive children are highly likely to become hypertensive adults and to have measurable target organ injury, particularly left ventricular hypertrophy and vascular stiffening. Ambulatory and home blood pressure monitoring may facilitate diagnosis. Primordial prevention of hypertension through public health implementation of healthier diet and increased physical activity will reduce the prevalence of primary hypertension, and evidence-based treatment guidelines should be implemented when hypertension is diagnosed. Further research to optimize recognition and diagnosis and clinical trials to better define outcomes of treatment are needed.

Severe parental phenotype associates with hypertension in children with ADPKD.

Early detection of hypertension in children with autosomal polycystic kidney disease (ADPKD) may be beneficial, but screening children at risk of ADPKD remains controversial. We investigated determinants of hypertension in children with ADPKD to help identify a subgroup of children at risk of ADPKD for whom screening for the disease and/or its complications would be more relevant. In a retrospective study including consecutive children with ADPKD aged 5-18years and followed at Saint-Luc Hospital Brussels between 2006 and 2020, we investigated the potential association between genotype, clinical characteristics and parental phenotype, and presence of hypertension. Hypertension was defined as blood pressure > P95 during 24-h ambulatory monitoring or anti-hypertensive therapy use. Parental phenotype was considered severe based on age at kidney failure, Mayo Clinic Imaging Classification and rate of eGFR decline. The study enrolled 55 children with ADPKD (mean age 9.9 ± 2.2years, 45% male), including 44 with a PKD1 mutation and 5 with no mutation identified. Nine (16%) children had hypertension. Hypertension in children was associated with parental phenotype severity (8/27 (30%) children with severe parental phenotype vs. 1/23 (4%) children with non-severe parental phenotype (p = 0.03)) and height-adjusted bilateral nephromegaly (6/9 (67%) children with bilateral nephromegaly vs. 3/44 (7%) children without bilateral nephromegaly (p < 0.001)). Severe parental phenotype is associated with higher prevalence of hypertension in children with ADPKD. Hence, children of parents with severe ADPKD phenotype may be those who will most benefit from screening of the disease and/or yearly BP measures. A higher resolution version of the Graphical abstract is available as Supplementary information.

Prevalence of Hypertension among Children Based on the New American Academy of Pediatrics Clinical Practice Guidelines.

In 2017, the American Academy of Pediatrics (AAP) updated clinical practice guidelines for the diagnosis and management of hypertension in children. The present study aimed to assess the prevalence of hypertension in Iranian children based on the latest guidelines. Data on 7301 student participants (3589 boys and 3712 girls) aged between 7-12 yr were assessed. The data were extracted from the fifth Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable Disease (CASPIAN V) school-based study conducted in the 30 provinces of Iran in 2015. Blood pressure (BP) was classified as normal, elevated BP, and stage 1 and 2 hypertension using weighted analysis and the 2017 AAP guidelines. All analyses were performed in STATA 14.0 statistical software, with findings presented in terms of prevalence. The overall prevalence of high BP in Iranian children was 14.7%. In addition, 15.1% of boys had high BP, with 9.4% and 1.7% of them with stage 1 and 2 hypertension, respectively. Moreover, 14.3% of girls had high BP, of which 10% had stage 1 and 1.3% with stage 2 hypertension. For elevated hypertension, it was observed in 4% of boys and 3% of girls. Using the 2017 AAP guidelines demonstrated a higher prevalence of hypertension in children (14.7%) in Iran. The prevalence of hypertension in boys was slightly higher compared to girls.

Determining the prevalence of childhood hypertension and its concomitant metabolic abnormalities using data mining methods in the Northeastern region of Hungary.

Identifying hypertension in children and providing treatment for it have a marked impact on the patients' long-term cardiovascular outcomes. The global prevalence of childhood hypertension is increasing, yet its investigation has been rather sporadic in Eastern Europe. Therefore, our goal was to determine the prevalence of childhood hypertension and its concomitant metabolic abnormalities using data mining methods. We evaluated data from 3 to 18-year-old children who visited the University of Debrecen Clinical Center's hospital throughout a 15-year study period (n = 92,198; boys/girls: 48/52%). We identified a total of 3,687 children with hypertension (2,107 boys and 1,580 girls), with a 4% calculated prevalence of hypertension in the whole study population and a higher prevalence in boys (4.7%) as compared to girls (3.2%). Among boys we found an increasing prevalence in consecutive age groups in the study population, but among girls the highest prevalences are identified in the 12-15-year age group. Markedly higher BMI values were found in hypertensive children as compared to non-hypertensives in all age groups. Moreover, significantly higher total cholesterol (4.27 ± 0.95 vs. 4.17 ± 0.88 mmol/L), LDL-C (2.62 ± 0.79 vs. 2.44 ± 0.74 mmol/L) and triglyceride (1.2 (0.85-1.69) vs. 0.94 (0.7-1.33) mmol/L), and lower HDL-C (1.2 ± 0.3 vs. 1.42 ± 0.39 mmol/L) levels were found in hypertensive children. Furthermore, significantly higher serum uric acid levels were found in children with hypertension (299.2 ± 86.1 vs. 259.9 ± 73.3 μmol/L), while glucose levels did not differ significantly. Our data suggest that the calculated prevalence of childhood hypertension in our region is comparable to data from other European countries and is associated with early metabolic disturbances. Data mining is an effective method for identifying childhood hypertension and its metabolic consequences.

S-43-1: THE CHANGING EPIDEMIOLOGY OF HYPERTENSION IN CHILDREN AND ADOLESCENTS

Some scientific concepts take time to overcome initial disbelief before they are finally embraced by the research community. One of these concepts is hypertension in children and adolescents. Little was known about childhood hypertension until the early 1980 s, mainly because blood pressure was not commonly measured in pediatric clinical practice. In the few cases blood pressure levels were determined to be abnormal in children, they were considered to be secondary hypertension resulting from an underlying condition. Even though secondary causes of hypertension tend to occur more often in hypertensive children than in adults, its prevalence is only about 1 percent overall, leaving primary hypertension especially in adolescents as the most frequent type. Even when there are many studies that have assessed the prevalence of hypertension in children and adolescents, scientists have faced difficulties to state this prevalence for three main reasons. To begin with, blood pressure normally changes with increasing age and body size. This makes establishing a fixed cutoff for values of systolic and diastolic blood pressure elevation rather challenging. This difficulty has led to the use of percentiles based on age, sex, and height to define the normal distribution, with a hypertensive level of blood pressure in the 95th percentile or higher. Another obstacle is that there is a variety of different definitions of hypertension used by the three most recent clinical practice guidelines coming from Europe, the United States and Canada. The last challenge is focused on the beat-to-beat blood pressure variability, the definition of hypertension requires that systolic and/or diastolic blood pressure to be persistently higher than the established thresholds on three separate occasions. Many cross-sectional studies with only one single measurement of blood pressure have not been able to define the prevalence of hypertension. The epidemiology of hypertension in childhood and adolescence can be linked to the worldwide obesity epidemic. Hypertension is more prevalent than before, with primary hypertension being the main type. It is well known that the factors related to primary hypertension can be modified, therefore childhood is a period in which prevention could be effective. If prevention is followed throughout childhood, it could contribute to a healthier young adulthood in the long run. Therefore, primordial prevention is an opportunity not to be missed.

The prevalence of hypertension in paediatric Turner syndrome: a systematic review and meta-analysis.

Cardiovascular related deaths account for over 40% of the excess mortality in Turner syndrome (TS). Hypertension, a modifiable risk factor for both aortic dilatation and dissection, is more commonly encountered in TS during childhood and adolescence. Treatment of hypertension is currently recommended beyond the age of 16 years in TS to help reduce the risk of aortic dissection. This study aims to determine the prevalence of hypertension in paediatric patients with TS and explore the associated methodologies of blood pressure evaluation reported in these studies. Three online databases were searched (Medline, Embase and Web of Science) for literature which reported a prevalence, or allowed calculation of prevalence, of hypertension in patients with TS who were 18 years of age or younger. Seventeen studies which met the primary eligibility criteria, with a total of 1948 patients, were included. The estimated pooled prevalence of hypertension in children and adolescents with TS was 16% (95% CI: 8.9-24.6%). There was significant heterogeneity detected between the studies. The prevalence of hypertension in those studies which assessed 24-h Ambulatory Blood Pressure Monitoring (ABPM) was 21.1% (95% CI: 15.2-27.6%) compared those which used another method of blood pressure measurement which was 13.5% (95% CI: 5.2-24.4%). Given the impact of hypertension with long-term health outcomes and the reversibility of these same outcomes by addressing abnormal blood pressure, prompt and early diagnosis of hypertension in young girls with TS should be prioritised. We recommend the use of 24-h ABPM in screening for hypertension in the paediatric TS population.

Hypertension Prediction in Primary School Students Using an Ensemble Machine Learning Method

Introduction: The prevalence of hypertension in children is increasing, and this complication is considered the most important risk factor for cardiovascular diseases in older age. Early detection and control of hypertension can prevent its progress and reduce its consequences. Machine learning methods can help predict this complication promptly and reduce cost and time. This study aimed to provide a model based on ensemble machine learning methods to more accurately predict the hypertension of primary school children. Method: This is an applied developmental study that was conducted using the information of 1287 primary school children aged 7 -13 years in Kashmar city. After data preprocessing, to achieve a more accurate diagnosis of hypertension in children, the output results of five common machine learning methods in disease diagnosis including decision tree, naive Bayesian, nearest neighbors, artificial neural network, and support vector machine using weighted majority voting method were combined. Results: The results showed that the accuracy, sensitivity, and specificity of the proposed model were 90.31%, 80.65%, and 93.54%, respectively, and compared to similar studies it performed better. Conclusion : The proposed model can better predict and diagnose hypertension in children and improve accuracy and reduce the error rate. This model can be a useful and early tool in the diagnosis of hypertension in children, reducing the consequences and costs of this complication and being a big step in the fight against hypertension.

The Prevalence of Hypertension in Children and Adolescents and Affecting Factors

The Prevalence of Hypertension in Children and Adolescents and Affecting Factors

The enigma of primary hypertension in childhood.

Beginning in the 1970s, hypertension in children and adolescents has been defined as systolic and/or diastolic blood pressure (BP) that is equal to or greater than the 95th percentile of the normal BP distribution in healthy children. The definition of hypertension in adults is based on longitudinal data that links a BP level with an increased risk for subsequent adverse outcomes related to hypertension including heart failure, kidney failure, stroke, or death. The statistical definition of hypertension continues to be used in childhood because there have been no data that link a BP level in childhood with a heightened risk for adverse outcomes in adulthood. Findings from clinical and epidemiologic research have advanced understanding of high BP in childhood. While hypertension in some children can be secondary to underlying kidney, cardiovascular, or endocrine disorder, it is now known that primary (essential) hypertension can be present in childhood. The prevalence of hypertension in childhood is approximately 2-5% and another 13-18% of children and adolescents have elevated BP and are at heightened risk for developing hypertension. The leading cause of childhood hypertension is primary hypertension, especially in adolescents. For children and adolescents with secondary hypertension, the treatment can focus on managing the underlying cause of hypertension. Less is known about managing primary hypertension in childhood, including diagnosis, evaluation, treatment, and possibilities for prevention. The phenotype of primary hypertension in childhood and recent findings will be discussed.

The prevalence of hypertension in children and adolescents with turner syndrome: a systematic review and meta-analysis

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Abstract P092: Sex Differences In Cardiometabolic Risk Factors Of Obese Adolescents

Background: The prevalence of hypertension in children and adolescents is rising, with 13% having elevated blood pressure and 5% having hypertension. Sex differences play a role in cardiovascular diseases in adults but are not well defined in youth. The objective of this study is to identify sex differences in obesity-mediated cardiometabolic risk factors in adolescents. Methods: This is a pilot study of n=82 obese children and adolescents recruited from a High BMI Clinic. Boys (n=42) and girls (n=40) were grouped by age (greater or less than age 12). Clinical data and blood samples were collected at a single time point (initial clinic visit). Serum sterols (glucocorticoids, mineralocorticoids, and sex hormones) were quantified via LC-MS/MS. Data are mean +/- standard deviation with analysis via 2-way ANOVA. Results: Mean BMI was 32.9 and 37.6 kg/m2 in children under/over age 12, respectively, with no difference in boys versus girls. Systolic blood pressure (SBP) was higher in boys and girls over compared to under age 12. Girls over age 12 had higher diastolic blood pressure (DBP) compared to boys (69.4 + 8.6 versus 66.4 + 5.1 mmHG; P&lt;0.05) which was associated with elevated aldosterone (272.5 + 369.9 versus 148.3 + 107.9 pg/mL; P&lt;0.05) and cortisol (100.3 + 69.8 versus 63.0 + 28.9 ng/mL; P&lt;0.05) concentrations. In contrast, there was no difference in the homeostatic model assessment for insulin resistance (HOMA-IR) between boys and girls. Conclusions: Despite having similar BMI and HOMA-IR, girls and boys had differences in DBP and serum sterols. Further analysis will refine associations of sex hormones with anthropometric, blood pressure, and glucose homeostasis measurements in obese girls and boys.

The Importance of Office Blood Pressure Measurement Frequency and Methodology in Evaluating the Prevalence of Hypertension in Children and Adolescents With Type 1 Diabetes: The SWEET International Database.

The prevalence of hypertension is higher in children and adolescents with type 1 diabetes (T1D) compared with those without. This retrospective analysis of a large cohort of children and adolescents with T1D from the SWEET (Better control in Pediatric and Adolescent diabeteS: Working to crEate CEnTers of Reference) international consortium of pediatric diabetes centers aimed to 1) estimate the prevalence of elevated office blood pressure (BP) and hypertension and 2) investigate the influence of BP measurement methodology on the prevalence of hypertension. A total of 27,120 individuals with T1D, aged 5-18 years, were analyzed. Participants were grouped into those with BP measurements at three or more visits (n = 10,440) and fewer than 3 visits (n = 16,680) per year and stratified by age and sex. A subgroup analysis was performed on 15,742 individuals from centers providing a score indicating BP measurement accuracy. Among participants with BP measurement at three or more visits, the prevalence of hypertension was lower compared with those with fewer than three visits (10.8% vs. 17.5% P < 0.001), whereas elevated BP and normotension were higher (17.5% and 71.7% vs. 15.3% and 67.1%, respectively; both P < 0.001). The prevalence of hypertension and elevated BP was higher in individuals aged ≥13 years than in younger ones (P < 0.001) and in male than female participants (P < 0.001). In linear regression models, systolic and diastolic BP was independently determined by the BP measurement methodology. The estimated prevalence of elevated BP and hypertension in children and adolescents with T1D is ∼30% and depends on the BP measurement methodology. Less frequent BP evaluation may overestimate the prevalence of hypertension.

Evaluation of Blood Pressure in Pediatric Survivors of Acute Lymphoblastic Leukemia and Healthy Children; A Case-control Study.

Background:The exact prevalence of hypertension in children surviving acute lymphoblastic leukemia (ALL) has not been fully estimated. The aim of this study was to investigate the prevalence of arterial hypertension (AH) and to determine the risk factors for the development of AH in children surviving ALL with current treatments.Materials and Methods:A total of 150 patients (84 males, 66 females, with an age range of 1–16 years) were included in the study. Demographic and clinical information of patients were initially recorded. Hypertension is defined as average systolic blood pressure (BP) and/or diastolic BP that is greater than the 95th percentile for gender, age, and height.Results:The mean age at the assessment of BP was 11.3 and 9.8 years in the ALL and control group, respectively. A total of 20.6% of survivors of ALL and 10% of controls had high BP. Most patients in both groups had normal BP (65.3% patients in ALL group and 75.4% subjects in the control group). The number of patients with hypertension was significantly higher in ALL patients as compared with the control group (P = 0.026).Conclusion:The prevalence of AH in children surviving ALL is higher than in children in the general population, which emphasizes the need for regular monitoring of BP in children surviving ALL and intervention in the lifestyle of this population. Careful follow-up of BP status is warranted for long-term survivors of childhood cancer.

Hypertension in Pediatric Acute Lymphoblastic Leukemia Patients: Prevalence, Impact, and Management Strategies.

Acute lymphoblastic leukemia (ALL) is the most common cancer diagnosed in children under the age of 18. While modern diagnostic technologies, risk-stratification, and therapy intensification have led to outstanding outcomes for many children with ALL, the side effects and consequences of therapy are not to be underestimated. Hypertension is a well-known acute and chronic side effect of treatment for childhood ALL, although limited data are available regarding the prevalence of hypertension in children undergoing treatment for ALL. In this review of hypertension in pediatric ALL patients, we examine the existing data on incidence and prevalence during treatment and in pediatric ALL survivors. We describe independent risk factors for development of hypertension along with treatment-related causes. Long-term consequences and the risk to survivors of pediatric ALL are further defined. While many ALL patients require antihypertensive medications during some portion of their treatment, there are no clear guidelines on treating inpatient hypertension given challenges that exist in recognizing and managing hypertension in this setting and in this population. Here, we propose an algorithmic approach to diagnose and treat pediatric ALL patients with HTN, along with monitoring and continuation versus cessation of antihypertensive therapy as an outpatient.

Deriving Normative Data on 24-Hour Ambulatory Blood Pressure Monitoring for South Asian Children (ASHA): A Clinical Research Protocol.

Background:The global prevalence of hypertension in children and adolescents has increased over the past 2 decades and is the strongest predictor of adult hypertension. South Asians have an increased prevalence of metabolic syndrome associated risk factors including abdominal obesity, diabetes, and hypertension. All these factors contribute to their increased cardiovascular disease burden. Accurate and early identification of hypertension in South Asian children is a necessary aspect of cardiovascular disease prevention. Ambulatory blood pressure monitoring (ABPM) is considered the gold-standard for pediatric blood pressure (BP) measurement. However, its utilization is limited due to the lack of validated normative reference data in diverse, multiethnic pediatric populations.Objective:The primary objective is to establish normative height-sex and age-sex-specific reference values for 24-h ABPM measurements among South Asian children and adolescents (aged 5-17 years) in Ontario and British Columbia, Canada. Secondary objectives are to evaluate differences in ABPM measurements by body mass index classification, to compare our normative data against pre-existing data from German and Hong Kong cohorts, and to evaluate relationships between habitual movement behaviors, diet quality, and ABPM measurements.Design:Cross-sectional study, quasi-representative sample.Setting:Participants will be recruited from schools, community centers, and places of worship in Southern Ontario (Greater Toronto and Hamilton area, including the Peel Region) and Greater Vancouver, British Columbia.Participants:We aim to recruit 2113 nonoverweight children (aged 5-17 years) for the primary objective. We aim to recruit an additional 633 overweight or obese children to address the secondary objectives.Measurements:Ambulatory BP monitoring measurements will be obtained using Spacelabs 90217 ABPM devices, which are validated for pediatric use. The ActiGraph GT3X-BT accelerometer, which has also been validated for pediatric use, will be used to obtain movement behavior data.Methods:Following recruitment, eligible children will be fitted with 24-h ABPM and physical activity monitors. Body anthropometrics and questionnaire data regarding medical and family history, medications, diet, physical activity, and substance use will be collected. Ambulatory BP monitoring data will be used to develop height-sex- and age-sex-specific normative reference values for South Asian children. Secondary objectives include evaluating differences in ABPM measures between normal weight, overweight and obese children; and comparing our South Asian ABPM data to existing German and Hong Kong data. We will also use compositional data analysis to evaluate associations between a child’s habitual movement behaviors and ABPM measures.Limitations:Bloodwork will not be performed to facilitate recruitment. A non-South Asian comparator cohort will not be included due to feasibility concerns. Using a convenience sampling approach introduces the potential for selection bias.Conclusions:Ambulatory BP monitoring is a valuable tool for the identification and follow-up of pediatric hypertension and overcomes many of the limitations of office-based BP measurement. The development of normative ABPM data specific to South Asian children will increase the accuracy of BP measurement and hypertension identification in this at-risk population, providing an additional strategy for primary prevention of cardiovascular disease.