Institute for Global Health and Development, Aga Khan University, Karachi, Pakistan.
Department of Medicine, Aga Khan University, Karachi, Pakistan.
J Health Popul Nutr. 2024 Jun 20;43(1):89. doi: 10.1186/s41043-024-00585-5.
Childhood obesity and hypertension are growing concerns globally, especially in developing countries. This study investigated the association between overall and central obesity at baseline, and prehypertension or hypertension at follow-up among preadolescent school children in urban Karachi, Pakistan.
This is a sub study with cohort design embedded within a feasibility trial on School Health Education Program in Pakistan (SHEPP) in preadolescents aged 6-11 years, attending two private schools conducted from 2017 to 2019. Hypertension or prehypertension at follow-up were the outcomes and obesity or central obesity at baseline were the exposure variables. Hypertension was defined as systolic blood pressure and/or diastolic blood pressure ≥ 95th percentile for age, sex, and height. Obesity was defined as body mass index for-age and sex ≥ 95th percentile, whereas central obesity was determined by waist circumference measurements ≥ 85th percentile of age, sex, and height specific cut-offs. Logistic regression analysis was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) to identify risk factors for hypertension and prehypertension.
Analysis was conducted for 908 participants, evenly distributed with 454 boys and 454 girls. Hypertension was observed in 19.8% of the preadolescents, with rates of 18.5% in boys and 21.0% in girls. Prehypertension was found in 16.8% of preadolescents, with 18% among boys and 16% among girls. Additionally, 12.8% of preadolescents were classified as obese and 29.8% had central obesity. Obesity at baseline was associated with hypertension at followup (OR 8.7, 95% CI 3.5, 20.4) in the final model after adjusting for age, gender, physical activity, sedentary behavior, fruits, vegetable intake and hypertension at baseline. Central obesity at baseline also yielded high odds, with prehypertension (OR 1.9, 95% CI 1.4, 2.8) and hypertension (OR 2.7, 95% CI 1.9, 3.9) at follow up in the final model.
This study highlights a concerning prevalence of hypertension and prehypertension among preadolescent school-going children. Obesity and central obesity at baseline emerged as significant predictive factors for hypertension or prehypertension at followup within this cohort. The findings emphasize the urgency of implementing comprehensive school health education programs aimed at early detection and effective management of hypertension during childhood and adolescence in school settings.
儿童肥胖和高血压是全球范围内日益严重的问题，尤其是在发展中国家。本研究旨在探讨巴基斯坦卡拉奇市城区青少年在校儿童中，基线时整体肥胖和中心性肥胖与随访时前期高血压或高血压之间的关联。
这是一项在巴基斯坦开展的学校健康教育计划（SHEPP）可行性试验中的子研究，采用队列设计，纳入年龄在 6-11 岁的青少年，来自两所私立学校，研究时间为 2017 年至 2019 年。随访时的高血压或前期高血压为结局，基线时的肥胖或中心性肥胖为暴露变量。高血压定义为收缩压和/或舒张压≥年龄、性别和身高的第 95 百分位。肥胖定义为体重指数（BMI）年龄和性别≥第 95 百分位，而中心性肥胖则通过腰围测量值确定，即年龄、性别和身高特定截断值的第 85 百分位以上。采用 logistic 回归分析计算比值比（OR）和 95%置信区间（CI），以确定高血压和前期高血压的危险因素。
本研究共纳入 908 名参与者，男女各占一半（454 名男孩和 454 名女孩）。19.8%的青少年患有高血压，其中男孩的患病率为 18.5%，女孩为 21.0%。青少年前期高血压的患病率为 16.8%，男孩为 18%，女孩为 16%。此外，12.8%的青少年肥胖，29.8%的青少年中心性肥胖。在最终模型中，在校青少年基线肥胖与随访时高血压相关（OR 8.7，95%CI 3.5，20.4），调整年龄、性别、体力活动、久坐行为、水果、蔬菜摄入量和基线高血压后。基线中心性肥胖也与随访时的前期高血压（OR 1.9，95%CI 1.4，2.8）和高血压（OR 2.7，95%CI 1.9，3.9）具有高度相关性。
本研究强调了在校青少年中高血压和前期高血压的令人担忧的高发率。肥胖和中心性肥胖是该队列中随访时高血压或前期高血压的重要预测因素。这些发现强调了在学校环境中实施全面的学校健康教育计划的紧迫性，以便在儿童和青少年时期早期发现和有效管理高血压。
