Medidas Preventivas

BMC Public Health
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Increasing blood pressure and its associated factors in Canadian children and adolescents from Canadian Health Measures Survey
BMC Public Health 2012, 12:388 doi:10.1186/1471-2458-12-388

Yipu Shi(yipu.shi@phac-aspc.gc.ca) Margaret de Groh (margaret.deGroh@phac-aspc.gc.ca) Howard Morrison (howard.morrison@phac-aspc.gc.ca)

ISSN Article type Submission date Acceptance date Publication date Article URL

1471-2458 Research article 19 December 2011 30 April 2012 29 May 2012 http://www.biomedcentral.com/1471-2458/12/388

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Increasing blood pressure and its associated factors in Canadian children and adolescents from Canadian health measures surveyYipu Shi1* * Corresponding author Email: yipu.shi@phac-aspc.gc.ca Margaret de Groh1 Email: margaret.de.groh@phac-aspc.gc.ca Howard Morrison1 Email: howard.morrison@phac-aspc.gc.ca
1

Science Integration Division, Center for Chronic Disease Prevention and Control, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, ON, Canada K1A 0K9

Abstract
Background
Canada is facing a childhoodobesity epidemic. Elevated blood pressure (BP) is a major complication of obesity. Reports on the impact of excess adiposity on BP in children and adolescents have varied significantly across studies. We evaluated the independent effects of obesity, physical activity, family history of hypertension, and socioeconomic status on BP in a nationally representative sample of children and adolescents.Methods
We analysed cross-sectional data for 1850 children aged 6 to 17 years who participated in the Canadian Health Measures Survey, Cycle 1, 2007–2009. Systolic BP (SBP) and diastolic BP (DBP) were age-, sex-, and height-adjusted to z-scores (SBPZ and DBPZ). Body mass index (BMI) z-scores were calculated based on World Health Organization growth standards. Multivariate linear regression wasused to evaluate the independent effects of relevant variables on SBPZ and DBPZ.

Results
For most age/sex groups, obesity was positively associated with SBP. Being obese was associated with higher DBP in adolescent boys only. The BP effect of obesity showed earlier in young girls than boys. Obese adolescents were estimated to have an average 7.6 mmHg higher SBP than normal weight adolescents. BMIhad the strongest effect on BP among obese children and adolescents. Moderately active adolescent boys had higher SBP (3.9 mmHg) and DBP (4.9 mmHg) than physically active boys. Family history of hypertension showed effects on SBP and DBP in younger girls and adolescent boys. Both family income and parent education demonstrated independent associations with BP in young children.

ConclusionsOur findings demonstrate the early impact of excess adiposity, insufficient physical activity, family history of hypertension, and socioeconomic inequalities on BP. Early interventions to reduce childhood obesity can, among other things, reduce exposure to prolonged BP elevation and the future risk of cardiovascular disease.

Background
Between 1978/9 and 2004, the prevalence of obesity among...