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：儿童高血压的诊断方案存在差异，目前最被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，并探讨其与营养状况变量的关联。
研究方法：本研究为纵向研究，纳入了所有就读于公立学校、年龄为7至10岁且获得家长/监护人知情同意的儿童，共计722名。首次评估时，儿童家属填写调查问卷，儿童接受人体测量学及血流动力学评估。血压分三次在不同时段进行测量。首次评估血压偏高的儿童于第二次随访时接受复评；持续存在血压偏高的儿童则于第三次随访时再次接受评估。
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、舒张压升高呈显著相关性，超重及肥胖儿童的血压水平更高。各评估时点中，高血压患病率最高的均为肥胖儿童。
研究结论：通过在不同时段为儿童测量血压，可降低动脉高血压的假阳性病例数量。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及早期干预至关重要。