Ferreira Haroldo S, Lúcio Glícia Maris A, Assunção Monica L, Silva Bárbara Coelho V, Oliveira Juliana S, Florêncio Telma Maria M T, Geraldes Amandio Aristides R, Horta Bernardo L
Faculty of Nutrition, Federal University of Alagoas, Maceió, Alagoas, Brazil.
Postgraduate Program in Nutrition, Faculty of Nutrition, Federal University of Alagoas, Maceió, Alagoas, Brazil.
PLoS One. 2015 Nov 23;10(11):e0142982. doi: 10.1371/journal.pone.0142982. eCollection 2015.
The prevalence of hypertension in childhood is increasing, and investigation of its distribution is important for planning timely interventions. This study assessed the prevalence of high blood pressure (HBP) and associated factors in students between 9 and 11 years of age enrolled in public and private schools in Maceió, Brazil. A cross-sectional study was performed in a probabilistic sample of students (10.3 ± 0.5 years). The students were selected from a systematic sampling of 80 schools (40 public and 40 private). To maintain similar proportions of students existing in public and private schools in Maceió, 21 and 14 students were randomly selected from each public and private school, respectively. The prevalence ratio (PR) was estimated using Poisson regression. A total of 1,338 students were evaluated (800 from public schools and 538 from private schools). No differences were observed between school types in terms of student age and gender (p > 0.05). The prevalence of obesity (19.9% vs. 9.0%; PR = 2.2; 95% CI = 1.67-2.92) and hypertension (21.2% vs. 11.4%; PR = 1.86; 95% CI = 1.45-2.40) were higher in private schools. The association between high blood pressure and type of school (public or private) remained statistically significant even after adjustment for obesity (PR = 1.53; 95% CI = 1.19-1.97).
(a) students from private schools have higher socioeconomic status, BMI, and HBP prevalence compared to those of public school; (b) among the evaluated students, the prevalence of obesity only partially explained the higher prevalence of high blood pressure among students from private schools. Other factors related to lifestyle of children from private schools may explain the higher prevalence of HBP. This results show the need to implement measures to promote healthy lifestyles in the school environment, since children with HBP are more likely to become hypertensive adults. Therefore, early detection and intervention in children with HBP is an important action for the prevention of hypertension in adulthood.
儿童高血压患病率呈上升趋势，对其分布情况进行调查对于及时规划干预措施至关重要。本研究评估了巴西马塞约市公立和私立学校9至11岁学生的高血压（HBP）患病率及相关因素。对学生概率样本（10.3±0.5岁）进行了横断面研究。学生从80所学校（40所公立和40所私立）的系统抽样中选取。为保持马塞约市公立和私立学校现有学生的相似比例，分别从每所公立和私立学校随机选取21名和14名学生。使用泊松回归估计患病率比（PR）。共评估了1338名学生（800名来自公立学校，538名来自私立学校）。在学生年龄和性别方面，未观察到学校类型之间存在差异（p>0.05）。私立学校的肥胖患病率（19.9%对9.0%；PR=2.2；95%CI=1.67 - 2.92）和高血压患病率（21.2%对11.4%；PR=1.86；95%CI=1.45 - 2.40）更高。即使在对肥胖进行调整后，高血压与学校类型（公立或私立）之间的关联仍具有统计学意义（PR=1.53；95%CI=1.19 - 1.97）。
（a）与公立学校学生相比，私立学校学生具有更高的社会经济地位、体重指数和HBP患病率；（b）在评估的学生中，肥胖患病率仅部分解释了私立学校学生中高血压患病率较高的原因。与私立学校儿童生活方式相关的其他因素可能解释了HBP患病率较高的原因。这些结果表明有必要在学校环境中采取措施促进健康的生活方式，因为患有HBP的儿童更有可能成为高血压成年人。因此，对患有HBP的儿童进行早期检测和干预是预防成人高血压的重要行动。
