Prevalence of Hypertension in Children from Public Schools

Abstract Background: There is a discrepancy between protocols used for the diagnosis of childhood hypertension, and the most recommended one is the measurement of blood pressure in at least three different moments. Objective: To identify the prevalence of hypertension in children, and to associate it with the nutritional status variable. Methods: This is a longitudinal study, which included all children aged 7 to 10 years enrolled in public schools and had the authorization of their parents/guardians, totaling 722 children. In the first evaluation, the child's family answered a questionnaire, and the child was submitted to anthropometric and hemodynamic evaluation. Blood pressure was measured three times at three different times. Children who had high blood pressure at the first moment were reassessed at a second time; those who persisted with high blood pressure were re-evaluated at a third moment. Results: The prevalence of high blood pressure at the first moment was 8.1%, being 3.2% in the second and 2.1% in the third. The nutritional status was significantly associated with the increase in systolic and diastolic blood pressures, being higher in overweight and obese children. The highest prevalence of high blood pressure was found in children classified as obese, at all moments. Conclusion: By performing blood pressure measurements of children at different moments, it was possible to reduce false-positive cases for arterial hypertension. The nutritional status was directly associated with the increase in blood pressure values. Performing the measurements in routine consultations becomes essential for diagnosis and early intervention.

研究背景：当前儿童高血压的诊断方案存在差异，目前最受推荐的诊断方式为至少在三个不同时段测量血压。
研究目的：明确儿童高血压的患病率，并将其与营养状况变量进行关联分析。
研究方法：本研究为纵向研究，纳入了所有就读于公立学校、且获得家长/监护人知情同意的7至10岁儿童，共计722名。首次评估时，儿童家属填写调查问卷，同时对儿童进行人体测量学与血流动力学评估。血压分别在三个不同时段各测量一次。首次评估血压偏高的儿童将在第二次时段接受复测；若复测仍显示血压偏高，则在第三次时段再次评估。
研究结果：首次评估时高血压患病率为8.1%，第二次评估为3.2%，第三次评估为2.1%。营养状况与收缩压、舒张压升高呈显著关联，超重与肥胖儿童的血压水平更高。在所有评估时段中，肥胖儿童的高血压患病率均为最高。
研究结论：通过在不同时段对儿童进行血压测量，可有效降低动脉高血压的假阳性病例数。营养状况与血压值升高呈直接正相关。在常规门诊中开展血压测量对于高血压的诊断与早期干预至关重要。