Screening For High Blood Pressure Research Articles

Pediatric High Blood Pressure Follow-Up Guideline Adherence in a Massachusetts Health Care System

ObjectivesTo describe adherence to the American Academy of Pediatrics’ (AAP) 2017 clinical practice guidelines for follow-up after high blood pressure (BP) screening by pediatric and family medicine providers in a Massachusetts health care system and to assess differences in receipt of follow-up according to child- and clinic-level factors. MethodsElectronic health record data were analyzed for children aged 3 to 17years who had an outpatient primary care visit during 2018 with a high BP screening (according to AAP guidelines). We classified AAP guideline adherent follow-up as BP follow-up within 6months after an elevated finding (+2-week buffer) and within 2weeks after a hypertensive finding (+2-week buffer). Differences in receipt of guideline adherent follow-up by child- and clinic-level factors were assessed via multilevel mixed effects logistic regression models. ResultsThe median age of the 4563 included children was 12years and 43% were female. Overall, guideline adherent follow-up was received by 17.7% of children within the recommended time interval; 27.4% for those whose index BP was elevated and 5.4% for those whose index BP was hypertensive. Modeling revealed older children and those belonging to clinics with more providers, smaller patient panels, and smaller proportion of Medicaid patients were more likely to receive adherent follow-up. ConclusionsFew children received guideline adherent BP follow-up and most differences in adherence were related to clinic resources. System-level interventions are needed to improve BP follow-up.

Impact of the 2017 AAP clinical guideline on the prevalence of high blood pressure among adolescents in Lagos, Nigeria.

Adolescent high blood pressure (HBP) can lead to several end-organ complications if it continues into adulthood. The 2017 AAP Guideline has lower blood pressure cut-off points and consequently leads to the identification of more people with high blood pressure. This study evaluated the impact of the 2017 American Academy of Pediatrics (AAP) Clinical Guideline on the prevalence of high blood pressure among adolescents when compared to the 2004 Fourth Report. A descriptive cross-sectional study was conducted from August 2020 to December 2020. The selection of 1,490 students, 10-19 years old, was by a two-stage sampling technique. Socio-demographic information and relevant clinical data were obtained using a structured questionnaire. Blood pressure was measured according to standard protocol. Categorical and numerical variables were summarized using frequency, percentages, mean, and standard deviation. The McNemar-Bowker test of symmetry was used to compare the blood pressure values in the 2004 Fourth Report and the 2017 AAP Clinical Guideline. The Kappa statistic was used to test for the degree of agreement between the 2004 Fourth Report and the 2017 AAP Clinical Guideline. The prevalence rates of high blood pressure, elevated blood pressure, and hypertension among adolescents were 26.7%, 13.8%, and 12.9%, respectively, using the 2017 AAP Clinical Guideline, and 14.5%, 6.1%, and 8.4%, respectively, using the 2004 Fourth Report. The degree of agreement between the 2004 and 2017 guidelines with respect to the classification of blood pressure was 84.8%. The Kappa statistic was 0.71 (CI: 0.67-0.75). The impact of this was a 12.2%, 7.7%, and 4.5% increase in the prevalence of high blood pressure, elevated blood pressure, and hypertension, respectively, using the 2017 AAP Clinical Guideline. The 2017 AAP Clinical Guideline detects a greater proportion of high blood pressure among adolescents. The adoption of this new guideline in clinical practice and its use in the routine screening of high blood pressure among adolescents is recommended.

Community Service Activities - Counseling And Blood Pressure Screening (Hypertension Disease)

High blood pressure, also known as hypertension, is a severe health issue that has a significant impact on the quality of life of individuals. The purpose of community service activities that emphasize counseling and screening for high blood pressure is to raise public awareness of the significance of maintaining normal blood pressure and detecting and preventing hypertension early. Through this community service project, it is anticipated that greater awareness will be generated regarding the significance of maintaining normal blood pressure and preventing hypertension. People are becoming more committed to adopting a healthy lifestyle and undergoing routine blood pressure tests. The result will be a decrease in the incidence of hypertension, an improvement in life quality, and a decrease in the severity of complications associated with high blood pressure. Counseling and screening for high blood pressure are concrete measures in efforts to prevent and control diseases that pose a threat to public health. Through this strategy, it is anticipated that individuals will be more aware of the significance of cardiovascular health and have the necessary knowledge and skills to maintain normal blood pressure.

Perceptions, insights, and attitudes (P.I.A.) of selected filipino female physicians on cardiovascular risks and diseases

Abstract Funding Acknowledgements Type of funding sources: None. Introduction In 2012, coronary heart disease and stroke are the leading causes of death worldwide, accounting for more than 31% of deaths from all causes. In 2020, PH statistics showed that ischemic heart diseases were the leading causes of death in the Philippines (PH), responsible for 17.3% of the total deaths. Objective To determine the knowledge, perceptions, insights and attitudes on cardiovascular disease (CVD) prevention, personal health-related lifestyle practices, and lifestyle counseling practices of selected female physicians who are practicing or training in the PH through an online survey. Methods A descriptive ambispective cross-sectional study where the survey questionnaire of Ameh, et al. (2019) was modified with the authors' permission, was conducted online and answered by consenting female physicians. 484 participants’ data were collated and analyzed. Results Majority had accurate responses for the CVD prevention knowledge items (Figures 1 and 2). Among the participants, 36.98% had hypertension, 32% were obese, 28.5% had dyslipidemia, and 17.2% had diabetes mellitus. Sleep of 6-8 hours is practiced by 60.33%, 53.51% eat vegetables and fruits daily, 55.79% prefer fish and seafood, 89.05% do not smoke, 61.2% take coffee or black tea daily, 84.51% have no regular exercise, and 30.79% of those who do only exercise for 10-20 minutes. Moreover, 67.98% add salt, soy or fish sauce to their meals, and 72.73% do not drink enough water daily. In addition, 44.42% do not undergo annual general check-up and 58.06% do not have a personal physician. Limitations due to COVID-19 pandemic, lack of education, and expensive screening tests are perceived to be major barriers to CVD screening. More than 90% of our participants practice health teachings on diabetes mellitus prevention, high blood pressure screening, cholesterol screening and management, nutrition, and weight management. Counseling on regular exercise, smoking, and alcohol abuse are being practiced by 88.02%, 85.74%, and 83.88% of our respondents, respectively. Conclusion There are female physicians who are not aware of the World Health Organization’s recommendations on the prevention of CVD, who do not do health teaching and counseling, and who practice unhealthy lifestyle. Changing physicians’ knowledge and behavior towards CVD prevention is a great challenge to improve standards of CVD prevention. Improvement and enhancement in education of both physicians and patients, together with more consultation time, financing for CVD prevention, and comprehensive, multidisciplinary preventive cardiology programs supported by government and societies in favor of prevention are some of the best ways to improve management of CVD risk factors and prevention.

Handgrip Strength Is Not Associated With High Blood Pressure and Does Not Have Good Discriminatory Power for High Blood Pressure in Adolescents

de Lima, TR and Silva, DAS. Handgrip strength is not associated with high blood pressure and does not have good discriminatory power for high blood pressure in adolescents. J Strength Cond Res 37(1): 46-54, 2023-Muscle strength measured by handgrip strength (HGS) was inversely and independently associated with high blood pressure (HBP). In addition, HGS has been used as a valuable indicator for monitoring pediatric health. This study aimed to investigate the association between HGS indexes and HBP, verify the discriminatory capacity of HGS to identify HBP in adolescents, and propose cut-points for HGS to be used in the early identification of HBP if good discriminatory power is identified between the variables. This was a cross-sectional study comprising 811 adolescents (male: 48.9%; age: 16.4 ± 1.3 years) from southern Brazil. Blood pressure was measured by the oscillometric method. Handgrip strength was assessed by a hand dynamometer and 3 different approaches were adopted: (a) HGS in kilogram-force, (b) normalized HGS (HGS/body mass), and (c) allometric HGS (HGS/body mass-0.67). Binary logistic regression was used to verify the association between HGS indexes and HBP, and the receiver operating characteristic (ROC) was used to determine the possible use of HGS as a diagnostic tool for HBP. Handgrip strength indexes were not associated with HBP (p > 0.05), and ROC analyses showed a nonsignificant discriminating accuracy for most of the HGS indexes analyzed (p > 0.05) in identifying HBP in boys and girls. The area under curve (AUC) values ranged from 0.499 (95% CI [0.403-0.596] for allometric HGS among overweight or obese boys) to 0.595 (95% CI [0.546-0.643] for HGS among boys). Handgrip strength was not associated with HBP, and its use in the screening of HBP in adolescents is not recommended.

Accuracy of anthropometric indicators of obesity to identify high blood pressure in adolescents-systematic review.

BackgroundAnthropometric indicators of obesity have been associated with blood pressure in adolescents. However, the accuracy of anthropometric indicators of obesity for screening for high blood pressure (HBP) in adolescents is not known. Thus, the aim of the present study was to summarize the set of evidence regarding the predictive ability of anthropometric indicators of obesity to identify HBP in adolescents.MethodsSearches were performed in five databases: MEDLINE, Web of Knowledge, Scopus, Scientific Electronic online (SciELO) and SportDiscus. The inclusion criteria for studies were: adolescents aged 10–19 years or mean age included in this range, observational and intervention studies, studies that proposed cutoff points for anthropometric indicators of obesity, and studies in English, Portuguese and Spanish. The methodological quality of studies was assessed using the QUADAS-2 instrument.ResultsTen studies met the inclusion criteria and had their information summarized. Based on the information described in these studies, the anthropometric indicators body mass index (BMI), waist circumference (WC), waist-to-height-ratio (WHtR), triceps skinfold thickness, body adiposity index, C index, body mass, waist-to-arm span ratio, arm fat area, average arm perimeter, fat percentage and arm span were likely to be used in high blood pressure (HBP) screening among adolescents. However, only one study showed acceptable values (moderate to high precision) in relation to the accuracy measurements of described cutoffs.ConclusionCaution is suggested in the use of anthropometric indicators of obesity for HBP screening in adolescents, in which a greater number of studies with accurate diagnostic tools are necessary.

High blood pressure screening in pharmacies during May Measurement Month campaigns in Switzerland

Purpose May Measurement Month (MMM) is an international screening campaign for arterial hypertension (HT) organised by the International Society of Hypertension and the World Hypertension League. It aims at raising the awareness of elevated blood pressure (BP) in the population. The goal of this analysis was to assess the results obtained in Swiss pharmacies during a 3-year campaign. Material and methods Swiss data from the MMM17 to MMM19 campaigns were extracted from the global MMM database. The analysis was conducted specifically on measures taken in pharmacies. BP and a questionnaire including demographical and clinical information were recorded for each participant. To assess BP control, ESH 2018 thresholds of <140/90 mmHg and ESH 2021 pharmacy-thresholds of <135/85 mmHg were used. Results From an initial sample of 3634 Swiss participants included during this 3-year campaign, 2567 participants (73.2%women and 26.8% men, p<.001) had their BP measured in triplicates in pharmacies. The first BP measurement was associated with 2.0 ± 4.9 mmHg effect on systolic blood pressure (SBP) (p<.001) and 0.7 ± 3.7 mmHg on diastolic blood pressure (DBP) (p<.001) compared to the mean of the second and third measurements. Based on the ESH 2018 and the ESH 2021 pharmacy thresholds, prevalence of HT (mean of second and third measurements) increased from 29.5% to 38.3%, respectively. In treated participants, 58.3% (279) had an average BP < 140/90 mmHg and 40.3% (193) had an average BP < 135/85 mmHg. Conclusions HT screening campaigns in pharmacies recruits mainly women. It helps the detection of untreated hypertensive participants and uncontrolled treated participants. Our data suggest that the average BP should be calculated on the second and third measurements due to a significant first measure effect in pharmacies measurement. Summary High blood pressure (BP) is a major global public health issue as the leading risk factor of global death. World-wide initiatives like May Measurement Month (MMM) aim to screen thousands of people each year to raise awareness of hypertension (HT). Switzerland participated in MMM 2017–2019 and screened more than 2500 participants in pharmacies. When adopting the recent proposed thresholds of HT diagnosis in pharmacies (ESH 2021 > 135/85 mmHg), HT prevalence in Switzerland is high (38.3%) with only 2/3 of treated hypertensive achieving the BP goals. Women are more likely to participate in such campaigns taking place in pharmacies. A first measurement effect (FME) was also present in pharmacies, highlighting that taking three BP measurements in pharmacies and discarding the first should be also considered in the pharmacy setting. Involving a routine pharmacy-based health care of patients would help to identify more hypertensive patients and uncontrolled treated patients, who may not have had access to BP measurement.

HYPERTENSIVE HEART DISEASE IN ADOLESCENCE. PRELIMINARY RESULTS OF THE PESESCAD-HTA STUDY

Objective: Identify the presence of hypertensive heart disease and its relationship with prehypertension and hypertension Design and method: A descriptive, cross-sectional study was carried out in 385 prehypertensive adolescents and 128 adolescents with essential hypertension, aged 12–15 years, from among a total of 1,545 adolescents screened in the School Screening for High Blood Pressure in Adolescents Project (PESESCAD-HTA). An echocardiogram was performed in 513 adolescents (prehypertensive plus hypertensive). For the multivariate analysis of risk factors related to LVH, a decision tree was obtained using the chi square automatic interaction detector (CHAID) technique. Results: Among prehypertensive and hypertensive adolescents, the prevalence of left ventricular hypertrophy was 6.49% (CI = 4.43–9.41) and 21.09% (CI = 14.92–58.95), respectively. In the sample of 513 individuals with prehypertension and hypertension, a decision tree was designed, using the chi square automatic interaction detector (CHAID) technique, with the presence of left ventricular hypertrophy as the dependent variable. Conclusions: The best predictors of left ventricular hypertrophy were a family history of obesity, and its interaction with the age and the sex of the adolescent.

BLOOD PRESSURE AWARENESS AND CONTROL IN SWISS PHARMACIES DURING MMM17–18 CAMPAIGNS

Objective: May Measurement Month (MMM) is a worldwide hypertension awareness campaign. The objective was to determine the usefulness of pharmacies in the detection of high blood pressure (BP) using the ESH 2018 and the ESH 2021 proposed threshold for diagnosis of hypertension in pharmacies. Design and method: Forty-one pharmacies in the Canton of Vaud (Switzerland) evaluated the participants during MMM17 campaign and 271 pharmacies in Switzerland evaluated the participants during MMM18 campaign. After obtaining inform consent form, BP and a short questionnaire focusing on basic demographic and clinical information were recorded. ESH 2018 threshold of 140/90mmHg and ESH 2021 pharmacy-threshold of 135/85mmHg were used for our analysis. Descriptive statistics and t-test were used appropriately. Results: 2060 participants had their BP measured in pharmacies. Mean age was 48.5 ± 19 years and almost ¾ of the participants were women (71.6% p &lt; 0.001). BP measurement in pharmacies was associated with a first measure effect of 2.8 ± 0.17 mmHg on SBP and 0.9 ± 0.13 mmHg on DBP. 689 (33.5%) and 840 (40.8%) participants presented a high BP based on ESH 2018 threshold and ESH 2021 pharmacy-based threshold respectively. In treated participants, 56.9% had average BP lower than 140/90mmHg. Conclusions: Mainly female participants had their BP measured in pharmacies. Screening for high BP in pharmacies is feasible and recruits mainly female participants. Based on pharmacy thresholds, the prevalence of hypertension was higher than expected for Switzerland. A first measure effect was also present in pharmacies, suggesting that three measures should be performed at pharmacies and the first one should be discarded from the mean BP calculation.

Height-based equations as screening tools for high blood pressure in pediatric practice, the GENOBOX study.

Due to the absence of easily applicable cut‐off points to determine high blood pressure or hypertension in children, as in the adult population, blood pressure is rarely measured in the pediatrician's clinical routine. This has led to an underdiagnosis of high blood pressure or hypertension in children. For this reason, the present study evaluate the utility of five equations for the screening of high blood pressure in children: blood pressure to height ratio, modified blood pressure to height ratio, new modified blood pressure to height ratio, new simple formula and height‐based equations. The authors evaluated 1599 children between 5 and 18 years. The performance of the five equations was analyzed using the receiver‐operating characteristics curves for identifying blood pressure above P90th according to the American Academy of Pediatrics Clinical Practice Guideline 2017. All equations showed an area under the curve above 0.882. The new modified blood pressure to height ratio revealed a high sensitivity whereas the height‐based equations showed the best performance, with a positive predictive value above 88.2%. Finally, all equations showed higher positive predictive values in children with overweight or obesity. The height‐based equation obtained the highest PPV values above 71.1% in children with normal weight and above 90.2% in children with overweight or obesity. In conclusions, the authors recommend the use of the height‐based equations equation because it showed the best positive predictive values to identify children with elevated blood pressure, independently of their sex, pubertal and weight status.

Screening for High Blood Pressure at the Dentist's Office.

BackgroundHigh blood pressure is a worldwide issue that can go undetected. Many are unaware of such a problem due to the lack of symptoms in early stages. Visiting the dentist can be a good place to screen for such health issues. Screening dental patients at every dental visit can be of great benefit. The aim of this study was to determine if screening for blood pressure at the dental office is efficient and beneficial for patients.MethodsThe HEYER VizOR Digital Blood Pressure Monitor was used to measure the blood pressure of all the patients visiting the dental clinic, ranging in age from 18 to 85. The study was comprised of patients who had never been diagnosed as hypertensive by a physician or if they had been diagnosed before.ResultsA total of 273 participants met the inclusion criteria. One hundred and thirty-seven (50.1%) patients had high blood pressure readings compared to 136 (49.8%) patients with normal blood pressure readings. It also showed that 54 (38%) of patients with high blood pressure readings had never been diagnosed by a physician with hypertension and were unaware of their blood pressure status. In addition, 83 (63.3%) of patients who had been diagnosed with hypertension by a physician had high blood pressure readings. The data also showed that 5.3% of patients diagnosed by their physician do not take their prescribed medication.ConclusionIn this study, we showed that screening blood pressure at the dental office can detect high blood pressure readings in dental patients. It is also a useful screening tool for blood pressure for diagnosed and undiagnosed patients. Screening dental patients at the dental office is a useful tool that can help in the screening for blood pressure and should be implemented at every visit.

Assessing Data Adequacy for High Blood Pressure Clinical Decision Support: A Quantitative Analysis.

This study examines guideline-based high blood pressure (HBP) and hypertension recommendations and evaluates the suitability and adequacy of the data and logic required for a Fast Healthcare Interoperable Resources (FHIR)-based, patient-facing clinical decision support (CDS) HBP application. HBP is a major predictor of adverse health events, including stroke, myocardial infarction, and kidney disease. Multiple guidelines recommend interventions to lower blood pressure, but implementation requires patient-centered approaches, including patient-facing CDS tools. We defined concept sets needed to measure adherence to 71 recommendations drawn from eight HBP guidelines. We measured data quality for these concepts for two cohorts (HBP screening and HBP diagnosed) from electronic health record (EHR) data, including four use cases (screening, nonpharmacologic interventions, pharmacologic interventions, and adverse events) for CDS. We identified 102,443 people with diagnosed and 58,990 with undiagnosed HBP. We found that 21/35 (60%) of required concept sets were unused or inaccurate, with only 259 (25.3%) of 1,101 codes used. Use cases showed high inclusion (0.9-11.2%), low exclusion (0-0.1%), and missing patient-specific context (up to 65.6%), leading to data in 2/4 use cases being insufficient for accurate alerting. Data quality from the EHR required to implement recommendations for HBP is highly inconsistent, reflecting a fragmented health care system and incomplete implementation of standard terminologies and workflows. Although imperfect, data were deemed adequate for two test use cases. Current data quality allows for further development of patient-facing FHIR HBP tools, but extensive validation and testing is required to assure precision and avoid unintended consequences.

Sustained high blood pressure and 24-h ambulatory blood pressure monitoring in Tanzanian adolescents

Estimates for prevalence of high blood pressure (BP) among adolescents in Africa vary widely and few studies, if any, have documented the results of the recommended stepwise BP screening. In this cross-sectional study in Tanzania, we aimed to estimate prevalence of sustained high BP in 3 public secondary schools using the American Academy of Pediatrics BP screening strategy. On Day 1, one screening automated office BP (AOBP) measurement (Step 1) was followed by two more AOBP measurements (Step 2). Repeat AOBP measurements were obtained after about one month on adolescents with high AOBP measurements on Day 1 (Step 3). Participants with sustained high BP underwent 24-h ambulatory BP monitoring (step 4). Of all 500 enrolled participants, the prevalence of high blood pressure at each step in the process was 36.6% (183), 25.6% (128), 10.2% (51), and 2.6%(13) respectively for Steps 1–4. All except 6 students completed all 4 steps of the BP screening algorithm as indicated. We conclude that diagnosis of hypertension in African adolescents should use multiple AOBP measurements over multiple days followed by 24-h ABPM. Screening for high BP in school settings appears to be feasible and could provide a platform for cardiovascular disease education and health promotion.

Prevalence of Hypertension, Pre-Hypertension and Associated Risk Factors in Rural Field Practice Area of a Private Medical College in South-India

Introduction: Globally hypertension is responsible for majority of mortality and morbidity among the non-communicable disease burden. A Community based cross sectional study was carried out to find the prevalence of hypertension, pre-hypertension and associated risk factors in the rural field practice area of Saveetha Medical College between January to March 2020.&#x0D; Methodology: The sample size calculated was 203 and equal numbers of participants between the age group of 30 to 60 years were selected from each of the 6 villages in field practice area by Stratified Random sampling method. A semi- structured pretested questionnaire was used for data collection.&#x0D; Results: The prevalence of hypertension and pre-hypertension was found to be 29.4% and 28.9% respectively. Major determinants of hypertension were age, marital status, diabetes mellitus, excess salt intake, sedentary lifestyle, stress, family history of hypertension and disturbed sleep pattern. Increased odds of hypertension were seen in marital status, diabetes mellitus and excess salt intake.&#x0D; Conclusion: Interventional measures done in the pre-hypertensive stage prevents risk of developing hypertension. Regular screening for high blood pressure, lifestyle modifications, treatment with antihypertensive medication are required to decrease the prevalence of hypertension in the community.

Development of a prediction model to target screening for high blood pressure in children

Targeted screening for childhood high blood pressure may be more feasible than routine blood pressure measurement in all children to avoid unnecessary harms, overdiagnosis or costs. Targeting maybe based e.g. on being overweight, but information on other predictors may also be useful. Therefore, we aimed to develop a multivariable diagnostic prediction model to select children aged 9–10 years for blood pressure measurement. Data from 5359 children in a population-based prospective cohort study were used. High blood pressure was defined as systolic or diastolic blood pressure ≥ 95th percentile for gender, age, and height. Logistic regression with backward selection was used to identify the strongest predictors related to pregnancy, child, and parent characteristics. Internal validation was performed using bootstrapping. 227 children (4.2%) had high blood pressure. The diagnostic model included maternal hypertensive disease during pregnancy, maternal BMI, maternal educational level, parental hypertension, parental smoking, child birth weight standard deviation score (SDS), child BMI SDS, and child ethnicity. The area under the ROC curve was 0.73, compared to 0.65 when using only child overweight. Using the model and a cut-off of 5% for predicted risk, sensitivity and specificity were 59% and 76%; using child overweight only, sensitivity and specificity were 47% and 84%. In conclusion, our diagnostic prediction model uses easily obtainable information to identify children at increased risk of high blood pressure, offering an opportunity for targeted screening. This model enables to detect a higher proportion of children with high blood pressure than a strategy based on child overweight only.

Prevalence and risk factors associated with hypertension among adults in a rural setting: the case of Ombe, Cameroon.

IntroductionHigh blood pressure is the most common cardiovascular disorder affecting approximately one billion people globally and remains a major contributor to the global burden of non-communicable diseases and mortality. Hypertension, once rare in traditional African societies, is now a major public health problem probably because of a rise in its risk factors. In sub-Saharan Africa, an estimated 74.7 million individuals live with hypertension. This study was designed to determine the prevalence and identify risk factors associated with hypertension in adults aged 21 years and above in Ombe village, a rural Cameroonian setting in sub-Saharan Africa.MethodsThis study was a cross-sectional community based survey from March to September 2016 (seven months) in the village of Ombe, a rural community in the southwest region of Cameroon. Following ethical clearance from the Institutional Review Board (IRB) of the Faculty of Health Science, University of Buea and administrative authorization, 243 participants (141 males and 102 females) through multi-stage sampling were randomly selected to take part in the study following consent which was voluntary and without any form of coercion. The principal research instrument was a questionnaire adapted from the WHO STEPwise approach to chronic disease risk factor surveillance- Instrument v2.1 which was administered to participants. The self-administered questionnaire collected socio-demographic information, data related to knowledge and practices related to hypertension, anthropometric data (weight and height from which the body mass index (BMI) was calculated). The blood pressure of study participants was measured. Data was entered using Microsoft Excel, then imported and analysed in SPSS v22.0. Frequencies and percentages were determined for categorical variables. Means and standard deviations (mean ± SD). Univariate and multivariate logistic regression analysis were used to investigate factors associated with high blood pressure (hypertension).ResultsThe results showed that 19.8% of the adult population had hypertension. Of the 243 respondents, 77.7% understood what is hypertension, 85% indicated that they could tell some consequences of high blood pressure (they indicated hypertension affects the heart, brain and kidneys) and 63.3% of study participants had never checked their blood pressure. Age greater than 40 years, harmful alcohol intake for more than 10 years, physical inactivity and obesity (BMI ≥ 25Kg/m2) were variables associated with hypertension on univariate analysis. Following multivariate analysis, independent risk factors for hypertension in our study were: physical inactivity (Adj. OR 2.6, 95%CI: 1.3-4.4, p = 0.021), regular alcohol consumption for more than 10 years (Adj. OR 2.9, 95%CI: 1.6-5.1, p = 0.014) and being older than 40 years of age: Adj. OR 2.5, 95%CI: 1.02-4.1, p = 0.002 in age category 41-60 years and this age related risk was even higher in persons older than 60 years of age Adj. OR 4.5, 95%CI: 2.1-6.3, p = 0.002.ConclusionThe findings of this study showed the prevalence of high blood pressure among adults in Ombe (a rural community in Cameroon) was 19.8%. Old age, alcohol consumption, and physical inactivity were independent risk factors for hypertension. Despite the population demonstrating knowledge about hypertension and its possible poor consequences on health, less than half had ever gone for blood pressure checks. Interventions to improve physical activity, reduce alcohol consumption and boost health seeking (high blood pressure screening) behaviour will be beneficial as preventive measures in combatting hypertension.

Body Composition and Serum Total Calcium Were Associated With Blood Pressure Among Children and Adolescents Aged 7-18 in China: A Cross-Sectional Study.

Background: This study aimed to assess the prevalence of childhood pre-hypertension and hypertension (elevated blood pressure, EBP) and explore their risk factors, especially the role of body composition and serum total calcium on EBP.Methods: From Nov 2013 to Jul 2014, a cross-sectional study was conducted in Hainan and Shaanxi Provinces in China. Two thousand two hundred eighty-three children and adolescents aged 7–18 underwent anthropometric and blood pressure measurements. Fasting blood was collected and serum total calcium was tested. Blood pressure standards from the updated Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents were used to classify BP groups based on age, sex and stature.Results: The overall prevalence of pre-hypertension and hypertension were 8.36 and 7.06%, respectively. Boys, older age, living in Hainan Province, excess adiposity and higher level of serum total calcium were found to be associated with EBP. Lean subjects had an average 3.87 mmHg decrease in systolic blood pressure (SBP) than normal weight groups. In contrary, overweight/obesity had increased SBP (3.69 mmHg) and diastolic blood pressure (DBP) (2.58 mmHg) than the normal weight group. Participants with high-level serum total calcium had a 1.60 mmHg increased SBP and 1.77 mmHg increased DBP than the low-level group. Compared with normal weight individuals, lean subjects appeared to have decreased odds of EBP (OR = 0.65, 95% CI: 0.43–0.98) but overweight/obese individuals were more likely to have EBP (OR = 2.67, 95% CI: 1.68–4.25). High-level of serum total calcium was associated with increased odds of EBP, the OR (95% CI) was 1.51 (1.17–1.94). The restrict cubic spline presented a linear relationship between serum total calcium and OR of EBP (P < 0.001).Conclusions: Body composition and serum total calcium were positively associated with blood pressure in children and adolescents. Serum calcium could be considered as an untraditional risk factors for high blood pressure screening along with other body composition indexes in clinical settings.

Performance of simplified tables for high blood pressure screening in a European pediatric population.

We assessed the performance of the simplified American Academy Pediatrics (AAP) 2017 guideline table and a simplified table based on the Fourth Report blood pressure (BP) reference tables for high BP screening compared with the European Society Hypertension 2016 guideline diagnostic thresholds. We obtained data from a cross-sectional, school-based screening study in north Greece during 2013-2016. BP was measured by mercury sphygmomanometer. The simple tables' performance for high BP was assessed by receiver operator characteristic curve analysis, area under the curve (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). The study population included 1846 children aged 6-12 years and 986 adolescents aged 13-18 years. Compared with the European Society Hypertension 2016 classification, the AAP 2017 simple table showed AUC 0.93, sensitivity 95.5%, specificity 91.6%, PPV 35.9%, and NPV 99.7%, whereas the Fourth Report one showed AUC 0.96, sensitivity 99.2%, specificity 93.2%, PPV 42.1%, and NPV 99.9%. Comparing the prevalence of high BP by the two tables, we found agreement in 96.9% of the participants, and disagreement in 3.1% (kappa coefficient = 0.85, P < 0.001). 20.8% of the adolescents classified for further screening by the Fourth Report, but not by the AAP 2017 simple table, had BP levels at the high-normal category. Simple tables for BP screening based on age present good performance to identify children and adolescents with high BP levels. However, they may provide high rate of false positive results, and the simple table by the AAP 2017 guideline may fail to classify some adolescents eligible for further BP evaluation.

High blood pressure screening in children and adolescents from Amargosa, Bahia: usefulness of anthropometric indices of obesity.

To determine the predictive power of body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR), and their respective cut-off points for high blood pressure (BP) screening in Brazilian children and adolescents. Cross-sectional study conducted with 1,139 students aged 6 to 17years. Body weight, height, WC, and BP were measured. High BP was classified as systolic or diastolic ≥ 95th percentile. Receiver Operating Characteristic (ROC) curves were constructed, and the area under the curve, sensitivity, and specificity were calculated. The prevalence of high BP was 27.0%. Anthropometric indices showed a significant association with high BP (accuracy ranging from 0.62 - 0.81), except for WHtR among male adolescents.Sensitivity was low, regardless of the anthropometric index, gender, and age group. BMI, WC, and WHtR were associated with high BP, but the cut-off points tested showed low sensitivity. Determining specific cut-off points for each population can enable the use of anthropometric indices in high BP screening.

Anthropometric indicators associated with high blood pressure in children living in urban and rural areas.

Objective:to evaluate anthropometric and demographic indicators associated with high blood pressure in children aged 6 to 10 years in urban and rural areas of Minas Gerais.Method:this is a cross-sectional study with 335 children. Anthropometric, demographic and blood pressure data were collected. The statistics analyzes were performed using the chi-square, t-student, Mann-Whitney and logistic regression tests, and the odds ratio was the association measure.Results:the prevalence of high blood pressure was significantly higher among rural children. In the urban area, the chance of high blood pressure was higher in children who had a high body mass index (2.97 [1.13-7.67]) and in the rural area, in those who had increased waist circumference (35.4 [3.0-406.2]) and the age range of 9-10 years (4.29 [1.46-12.6]).Conclusion:elevated body mass index and waist circumference were important anthropometric indicators for high blood pressure, as well as age in children living in rural area. The evaluation of body mass index and waist circumference, in addition to nutritional assessments, represents an important action for the screening of high blood pressure in children from different territorial contexts.