What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Hypertension and Pre-hypertension (n=388). Intervention: Overweight and obesity vs. Lean/normal weight. Primary outcome: Pre-hypertension or hypertension (RR 1.57, 95% CI 1.194-2.087, p=0.0017).

March 1, 2015Open Access

Prevalence of Hypertension and Pre-hypertension in 13-17 Year Old Adolescents Living in Mthatha - South Africa: a Cross-Sectional Study

Key Result

Overweight and obesity were associated with a significantly increased risk of pre-hypertension or hypertension among South African adolescents (RR 1.57, 95% CI 1.194-2.087, p=0.0017).

Study Design

Type

Cross-Sectional (n=388)

Multicenter

Structured PICO

Population

388 school-attending adolescents aged 13-17 years in a peri-urban South African community assessed for the prevalence of hypertension and its association with anthropometric measures.

Outcome

Prevalence of pre-hypertension and hypertension and their relationship with selected anthropometric measurements

Main Result

Relative Risk: 1.57 (95% CI 1.194–2.087)

p-value: p=0.0017

Limitations

Cross-sectional design limits the ability to establish causal relationships
Many more females than males participated in the study, potentially skewing overall prevalence estimates
Blood pressure was measured on a single occasion rather than across multiple visits

Abstract

Background: Hypertension is one of the most common risk factors for cardiovascular diseases (CVDs), yet not much effort is being invested in early diagnosis and control of the condition in susceptible children. The aim of this study was to investigate the prevalence of pre-hypertension and hypertension in peri-urban school-attending adolescents and explore the relationship between blood pressure and selected anthropometric measurements. Methods: A cross-sectional study of adolescents aged 13-17 years was performed. Data on height, weight, waist and hip circumferences as well as blood pressure were collected from all participants. Body mass index (BMI) and blood pressure percentiles were calculated. Results: The overall prevalence of obesity was 20.4% while the prevalence of hypertension and pre-hypertension was 21.2% and 12.3%, respectively. The prevalence of hypertension and pre-hypertension in males was 22.0% and 13.6% compared to 20.9% and 16.5% in females, respectively. Both conditions were associated with higher BMI in both girls and boys. While mean systolic blood pressure (SBP) was positively associated with higher BMI and waist circumference (WC) in males and females, it correlated negatively with hip circumference (HC) in males. On the other hand, mean diastolic blood pressure (DBP) correlated better with HC in males but only weakly in females. Conclusion: Adolescent learners in Mthatha had a high prevalence of hypertension and pre-hypertension which were associated with overweight and obesity. Results highlight the urgent need for screening in view of early detection and implementation of intervention strategies to prevent a high incidence of CVDs in this country.

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