Cent Eur J Public Health 2015, 23(1):59-64 | DOI: 10.21101/cejph.a3922

Prevalence of Hypertension and Pre-hypertension in 13-17 Year Old Adolescents Living in Mthatha - South Africa: a Cross-Sectional Study

Benedicta N. Nkeh-Chungag1, Anna M. Sekokotla2, Constance Sewani-Rusike2, Ambrose Namugowa2, Jehu E. Iputo2
1 Zoology Department, Faculty of Science, Engineering and Technology, Walter Sisulu University, Mthatha, South Africa
2 Physiology Department, Faculty of Health Sciences, Walter Sisulu University, Mthatha, South Africa

Background: Hypertension is one of the most common risk factors for cardiovascular diseases (CVDs), yet not much effort is being invested in early diagnosis and control of the condition in susceptible children. The aim of this study was to investigate the prevalence of pre-hypertension and hypertension in peri-urban school-attending adolescents and explore the relationship between blood pressure and selected anthropometric measurements.

Methods: A cross-sectional study of adolescents aged 13-17 years was performed. Data on height, weight, waist and hip circumferences as well as blood pressure were collected from all participants. Body mass index (BMI) and blood pressure percentiles were calculated.

Results: The overall prevalence of obesity was 20.4% while the prevalence of hypertension and pre-hypertension was 21.2% and 12.3%, respectively. The prevalence of hypertension and pre-hypertension in males was 22.0% and 13.6% compared to 20.9% and 16.5% in females, respectively. Both conditions were associated with higher BMI in both girls and boys. While mean systolic blood pressure (SBP) was positively associated with higher BMI and waist circumference (WC) in males and females, it correlated negatively with hip circumference (HC) in males. On the other hand, mean diastolic blood pressure (DBP) correlated better with HC in males but only weakly in females.

Conclusion: Adolescent learners in Mthatha had a high prevalence of hypertension and pre-hypertension which were associated with overweight and obesity. Results highlight the urgent need for screening in view of early detection and implementation of intervention strategies to prevent a high incidence of CVDs in this country.

Keywords: adolescent, hypertension, pre-hypertension, obesity, overweight, South Africa

Received: May 6, 2013; Revised: August 25, 2014; Accepted: August 25, 2014; Published: March 1, 2015  Show citation

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Nkeh-Chungag BN, Sekokotla AM, Sewani-Rusike C, Namugowa A, Iputo JE. Prevalence of Hypertension and Pre-hypertension in 13-17 Year Old Adolescents Living in Mthatha - South Africa: a Cross-Sectional Study. Cent Eur J Public Health. 2015;23(1):59-64. doi: 10.21101/cejph.a3922. PubMed PMID: 26036100.
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    References

    1. Rodrigues AN, Abreu GR, Resende RS, Goncalves WL, Gouvea SA. Cardiovascular risk factor investigation: a pediatric issue. Int J Gen Med. 2013;6:57-66. Go to original source... Go to PubMed...
    2. Rossouw HA, Grant CC, Viljoen M. Overweight and obesity in children and adolescents: the South African problem. S Afr J Sci. 2012;108(5/6):31-7. Go to original source...
    3. Toriola AL, Moselakgomo V, Shaw B, Goon DT. Overweight, obesity and underweight in rural black SouthAfrican children. SAfr J Clin Nutr. 2012;25(2):57-61. Go to original source...
    4. Gupta N, Goel K, Shah P, Misra A. Childhood obesity in developing countries: epidemiology, determinants, and prevention. Endocr Rev. 2012 Feb;33(1):48-70. Go to original source... Go to PubMed...
    5. BonvecchioA, Safdie M, Monterrubio EA, Gust T, Villalpando S, Rivera JA. Overweight and obesity trends in Mexican children 2 to 18 years of age from 1988 to 2006. Salud Publica Mex. 2009;51 Suppl 4:S586-94. Go to original source... Go to PubMed...
    6. Kimani-Murage EW, Kahn K, Pettifor JM, Tollman SM, Dunger DB, Gómez-Olivé XF, et al. The prevalence of stunting, overweight and obesity, and metabolic disease risk in rural SouthAfrican children. BMC Public Health. 2010 Mar 25;10:158-70. Go to original source... Go to PubMed...
    7. Kotchen TA. Obesity-related hypertension: epidemiology, pathophysiology, and clinical management.Am J Hypertens. 2010 Nov;23(11):1170-8. Go to original source... Go to PubMed...
    8. Kim J, Bhattacharjee R, Kheirandish-Gozal L, Khalyfa A, Sans Capdevila O, Tauman R, et al. Insulin sensitivity, serum lipids, and systemic inflammatory markers in school-aged obese and nonobese children. Int J Pediatr. 2010;2010:846098. doi: 10.1155/2010/846098. Go to original source... Go to PubMed...
    9. Raj M. Obesity and cardiovascular risk in children and adolescents. Indian J Endocrinol Metab. 2012 Jan;16(1):13-9. Go to original source... Go to PubMed...
    10. Ibrahim MM, Damasceno A. Hypertension in developing countries. Lancet. 2012 Aug 11;380(9841):611-9. Go to original source... Go to PubMed...
    11. Hansen ML, Gunn PW, Kaelber DC. Underdiagnosis of hypertension in children and adolescents. JAMA. 2007 Aug 22;298(8):874-9. Go to original source... Go to PubMed...
    12. Flynn JT, Falkner BE. Obesity hypertension in adolescents: epidemiology, evaluation, and management. J Clin Hypertens (Greenwich). 2011 May;13(5):323-31. Go to original source... Go to PubMed...
    13. Thompson M, Dana T, Bougatsos C, Blazina I, Norris SL. Screening for hypertension in children and adolescents to prevent cardiovascular disease. Pediatrics. 2013 Mar;131(3):490-525. Go to original source... Go to PubMed...
    14. Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents; National Heart, Lung, and Blood Institute. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics. 2011 Dec;128 Suppl 5:S213-56. Go to original source... Go to PubMed...
    15. Falkner B, Lurbe E, Schaefer F. High blood pressure in children: clinical and health policy implications. J Clin Hypertens (Greenwich). 2010 Apr;12(4):261-76. Go to original source... Go to PubMed...
    16. Genovesi S, Giussani M, Pieruzzi F, Vigorita F, Arcovio C, Cavuto S, et al. Results of blood pressure screening in a population of school-aged children in the province of Milan: role of overweight. J Hypertens. 2005 Mar;23(3):493-7. Go to original source... Go to PubMed...
    17. Genovesi S, Antolini L, Gallieni M, Aiello A, Mandal SK, Doneda A, et al. High prevalence of hypertension in normal and underweight Indian children. J Hypertens. 2011 Feb;29(2):217-21. Go to original source... Go to PubMed...
    18. Salman Z, Kirk GD, Deboer MD. High rate of obesity-associated hypertension among primary schoolchildren in Sudan. Int J Hypertens. 2011;2011:629492. doi: 10.4061/2011/629492. Go to original source... Go to PubMed...
    19. Kemp C, PienaarAE, SchutteA. The prevalence of hypertension and the relationship with body composition in Grade 1 learners in the North West Province of South Africa. S Afr J Sports Med. 2011;23(4):117-22. Go to original source... Go to PubMed...
    20. World Health Organization. WHO STEPwise approach to surveillance (STEPS). Geneva: WHO; 2008.
    21. Benkeser RM, Biritwum R, HillAG. Prevalence of overweight and obesity and perception of healthy and desirable body size in urban, Ghanaian women. Ghana Med J. 2012 Jun;46(2):66-75. Go to PubMed...
    22. Pate RR, Stevens J, Webber LS, Dowda M, Murray DM, Young DR, et al. Age-related change in physical activity in adolescent girls. J Adolesc Health. 2009 Mar;44(3):275-82. Go to original source... Go to PubMed...
    23. Pate RR, Dowda M, O'Neill JR, Ward DS. Change in physical activity participation among adolescent girls from 8th to 12th grade. J Phys Act Health. 2007 Jan;4(1):3-16. Go to original source... Go to PubMed...
    24. Prättälä R, Sippola R, Lahti-Koski M, Laaksonen MT, Mäkinen T, Roos E. Twenty-five year trends in body mass index by education and income in Finland. BMC Public Health. 2012 Oct 31;12:936. doi: 10.1186/14712458-12-936. Go to original source... Go to PubMed...
    25. LjungvallA, Zimmerman FJ. Bigger bodies: long-term trends and disparities in obesity and body-mass index among U.S. adults, 1960-2008. Soc Sci Med. 2012 Jul;75(1):109-19. Go to original source... Go to PubMed...
    26. Misra A, Khurana L. Obesity and the metabolic syndrome in developing countries. J Clin Endocrinol Metab. 2008 Nov;93(11 Suppl 1):S9-30. Go to original source... Go to PubMed...
    27. ErlingsdottirA, Indridason OS, Thorvaldsson O, Edvardsson VO. Blood pressure in children and target-organ damage later in life. Pediatr Nephrol. 2010 Feb;25(2):323-8. Go to original source... Go to PubMed...
    28. Jonk AM, Houben AJ, de Jongh RT, Serné EH, Schaper NC, Stehouwer CD. Microvascular dysfunction in obesity: a potential mechanism in the pathogenesis of obesity-associated insulin resistance and hypertension. Physiology (Bethesda). 2007 Aug;22:252-60. Go to original source... Go to PubMed...
    29. Plachta-Danielzik S, Landsberg B, Johannsen M, Lange D, Müller MJ. Association of different obesity indices with blood pressure and blood lipids in children and adolescents. Br J Nutr. 2008 Jul;100(1):208-18. Go to original source... Go to PubMed...
    30. Schneider HJ, Friedrich N, Klotsche J, Pieper L, Nauck M, John U, et al. The predictive value of different measures of obesity for incident cardiovascular events and mortality. J Clin Endocrinol Metab. 2010 Apr;95(4):1777-85. Go to original source... Go to PubMed...
    31. Oboh HA, Adedeji AA. Correlation of waist-hip-ratio and waist-heightratio to cardiovascular risks factors in a Nigerian population. Nig Q J Hosp Med. 2011 Jan-Mar;21(1):16-24.
    32. Liu Y, Tong G, Tong W, Lu L, Qin X. Can body mass index, waist circumference, waist-hip ratio and waist-height ratio predict the presence of multiple metabolic risk factors in Chinese subjects? BMC Public Health. 2011 Jan 13;11:35-41. Go to original source... Go to PubMed...
    33. Chen TL, Choy CS, Chan WY, Chen CH, Liao CC. Waist-to-height ratio and elevated blood pressure among children in Taiwan. Indian Pediatr. 2012 Jun;49(6):463-6. Go to original source... Go to PubMed...
    34. Kruger HS, Faber M, Schutte AE, Ellis SM. A proposed cutoff point of waist-to-height ratio for metabolic risk in African township adolescents. Nutrition. 2013 Mar;29(3):502-7. Go to original source... Go to PubMed...
    35. Dubey RK, Oparil S, Imthurn B, Jackson EK. Sex hormones and hypertension. Cardiovasc Res. 2002 Feb 15;53(3):688-708. Go to original source... Go to PubMed...
    36. Palmieri D, Perego P, Palombo D. Estrogen receptor activation protects against TNF-α-induced endothelial dysfunction. Angiology. 2014 Jan;65(1):17-21. Go to original source... Go to PubMed...
    37. Kolovou G, Giannakopoulou V, Vasiliadis Y, Bilianou H. Effects of estrogens on atherogenesis. Curr Vasc Pharmacol. 2011 Mar;9(2):244-57. Go to original source... Go to PubMed...
    38. BeLue R, Okoror TA, Iwelunmor J, Taylor KD, Degboe AN, Agyemang C, et al.An overview of cardiovascular risk factor burden in sub-Saharan African countries: a socio-cultural perspective. Global Health. 2009 Sep 22;5:10. doi: 10.1186/1744-8603-5-10. Go to original source... Go to PubMed...
    39. Kibar AE, Pac FA, Balli S, Oflaz MB, Ece I, Bas VN, et al. Early subclinical left-ventricular dysfunction in obese nonhypertensive children: a tissue Doppler imaging study. Pediatr Cardiol. 2013Aug;34(6):1482-90. Go to original source... Go to PubMed...
    40. Luma GB, Spiotta RT. Hypertension in children and adolescents. Am Fam Physician. 2006 May 1;73(9):1558-68. Go to PubMed...
    41. Sorof JM, Alexandrov AV, Cardwell G, Portman RJ. Carotid artery intimal-medial thickness and left ventricular hypertrophy in children with elevated blood pressure. Pediatrics. 2003 Jan;111(1):61-6. Go to original source... Go to PubMed...
    42. Chen X,WangY.Tracking of blood pressure from childhood to adulthood: a systematic review and meta-regression analysis. Circulation. 2008 Jun 24;117(25):3171-80. Go to original source... Go to PubMed...
    43. Ujunwa FA, Ikefuna AN, Nwokocha AR, Chinawa JM. Hypertension and prehypertension among adolescents in secondary schools in Enugu, South East Nigeria. Ital J Pediatr. 2013 Nov 2;39:70. doi: 10.1186/18247288-39-70. Go to original source... Go to PubMed...
    44. Ellenga Mbolla BF, Okoko AR, Mabiala Babela JR, Ekouya Bowassa G, Gombet TR, Kimbally-Kaky SG, et al. Prehypertension and hypertension among schoolchildren in Brazaville, Congo. Int J Hypertens. 2014;2014:803690. doi: 10.1155/2014/803690. Go to original source... Go to PubMed...

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