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Elevated Blood Pressure Among Zimbabwean Urban Primary School Children Aged 5–11 Years
American Journal of Pediatrics
Volume 3, Issue 5, September 2017, Pages: 51-57
Received: Feb. 13, 2017; Accepted: Apr. 1, 2017; Published: Oct. 23, 2017
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Dube Adiele, Department of Emergency Medical Care, Emergency Medical Ambulances Services, Kwekwe, Zimbabwe
Gundani Patrick Dube Morgan, Department of Sports Science and Coaching, Faculty of Applied Sciences, National University of Science and Technology, Bulawayo, Zimbabwe
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Following few publications available with data on blood pressure profiles of Zimbabwean population, especially children and adolescents, few data exist on urban and rural school going children. The aims of this study were to examine the incidence of hypertension (HT) among Zimbabwean urban children residing in Kwekwe; and to determine the relationship between body mass index (BMI) and blood pressure (BP) among them. The study involved 480 primary school children (230 boys and 250 girls) aged 5–11 years. Stature and body weight were measured using standard procedures. BMI for gender and age defined overweight. BP was monitored for thrice consecutively using validated electronic devices (Omron 7051T). HT was determined as the average of three separate BP readings where the systolic or diastolic blood pressure was ≥ 95th percentile for age and sex. The incidence of overweight among the girls (3.6%) was higher compared with the boys (2.7%). Both systolic and diastolic pressures (SBP and DBP) increase with age in both sexes. Potential development of hypertension among the children is noticeable at Early Childhood Development (ECD) level for both boys and girls; 1.8% and 1.5% respectively and ranged from 0.8% to 1.8% for boys and 2.0% to 5.3% for girls. The overall incidence of hypertension was 1.5% and 2.6% in boys and girls, respectively. The highest noticeable value for boys was at ECD and decreased with increase in grade level. The incidence of hypertension (SBP > 95th percentile) was 0.4% and 0.2% in boys and girls, respectively. For the girls there was a progressive increase in the tendency towards development of hypertension from ECD to 6th grade except a small decrease in 3rd and 4th grade levels. Girls in the 6th grade level showed the highest value of incidence of hypertension (5.3%). The blood pressures (SBP and DBP) significantly correlated with age, stature, body mass and BMI (P<0.05). The findings demonstrate that elevated blood pressure is prevalent among urban Zimbabwean children and that there is need for routine measurement of BP to children residing in this region as part of physical examination for physical activity in schools. The use of BMI cutoffs tailored to metabolic risks may be vital for assessment of overweight. BP increased with age in both sexes, and this significantly correlated with age, stature, body weight and BMI.
Overweight, Body Mass Index, Blood Pressure, Mining Industry, Urban Children, Zimbabwe
To cite this article
Dube Adiele, Gundani Patrick Dube Morgan, Elevated Blood Pressure Among Zimbabwean Urban Primary School Children Aged 5–11 Years, American Journal of Pediatrics. Vol. 3, No. 5, 2017, pp. 51-57. doi: 10.11648/j.ajp.20170305.15
Copyright © 2017 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
MartõÂn-Espinosa N, DõÂez-FernaÂndez A, SaÂnchez-LoÂpez M, Rivero-Merino I, Lucas-De La Cruz L, Solera-MartõÂnez M, et al. (2017) Prevalence of high blood pressure and association with obesity in Spanish schoolchildren aged 4±6 years old. PLoS ONE 12 (1): e0170926. doi: 10.1371/journal
Kamath VG, Parthage PM, Pattanshetty S, Kamath A, Balakrishnan A, Mishra T, et al. Prevalence of hypertension in the paediatric population in Coastal South India. Aust Med J. 2010; 3 (11): 695–8.
Vos LE, Oren A, Bots ML, Gorissen WH, Grobbee DE, Uiterwaal CS. Does a routinely measured blood pressure in young adolescence accurately predict hypertension and total cardiovascular risk in young adulthood? J Hypertens. 2003; 21 (11): 2027–34.
Lane DA, Gill P. Ethnicity and tracking blood pressure in children. J Hum Hypertens. 2004; 18: 223e228.
Longo D, Fauci A, Kasper D, et al. Harrison principles of internal medicine. 18th ed. Tehran: Andishe Rafiee; 2012. p. 439.
Raj M, Sundaram KR, Paul M, Deepa AS, Kumar RK. Obesity in Indian children: time trends and relationship with hypertension. Natl Med J India. 2007 Nov-Dec; 20 (6): 288-93.
Bartosh SM, Aronson AJ. Childhood hypertension: An update on etiology, diagnosis and treatment. Pediatr Clin North Am 1999; 46: 235-52.
Rosner B, Prineas RJ, Loggie JMH, Daniels SR. Blood pressure nomograms for children and adolescents, by height, sex and age, in the United States. J Pediatr 1993; 123: 871–86.
Moore WE, Stephens A, Wilson T, Eichner JE. Body mass index and blood pressure screening in a rural public school system: The Healthy Kids Project. Prev Chronic Dis. 2006; 3 (4): A114.
Sun SS, Grave GD, Siervogel RM, Pickoff AA, Arslanian SS, Daniel SR. Systolic blood pressure in childhood predicts hypertension and metabolic syndrome later in life. J Paediatr. 2006; 119 (2): 237–46.
Tarlton PA. Prevalence of elevated blood pressure in Hispanic versus non-Hispanic 6th graders. J Sch Nurs. 2007; 23 (1): 47–52.
Kidy F, Rutebarika D, Lule SA, Kizza M, Odiit A, Webb EL, et al. Blood pressure in primary school children in Uganda: a cross-sectional survey. BMC Public Health. 2014; 14: 1223.
Amusa LO, Goon DT. Blood pressure among overweight children aged 7-13 years in 10 rural communities in South Africa: The Tshannda Longitudinal Study. Pak J Med Sci 2011; 27 (3): 664-667.
Raj M, Sundaram R, Paul M, Kumar K. Blood pressure distribution in Indian children. Indian Pediatr. 2010 Jun; 47 (6): 477-85.
Obesity Task Force, World Health Organization. Global Strategy On Diet, Physical Activity And Health: Obesity and Overweight. 2005 [Online]. Available: pdf [2015, 25 October].
Armstrong MEG, Lambert MI, Sharwood KA, Lambert EV. Obesity and overweight in South African primary school children-the Health of the Nation Study. SA Med J. 2006; 96 (5): 439–44.
Reddy SP, Resnicow K, James S, Funani IN, Kambaran NS, Omardien RG, et al. Rapid increases in overweight and obesity among South African adolescents: comparison of data from the South African National Youth Risk Behaviour Survey in 2002 and 2008. Am J Publ Health. 2012; 102 (2): 202–68.
Marfell-Jones M, Olds T, Stew A, Carter L. International standards for anthropometric assessment. The International Society for the Advancement of Kinanthropometry; Australia: 2006.
Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. Br Med J. 2000; 320 (7244): 1240–3.
Hari P, Bagga A, Srivastava RN. Sustained hypertension in children. Indian Pediatr 2000; 37: 268-74.
Amusa LO, Mbhenyane XG, Toriola AL, Amey KA, Ndaba K, Monyeki KD. The prevalence of hypokinetic risk factors in rural South African children: The Tshannda Longitudinal Study. AJPHERD 2007; Supplement: 86-101.
Monyeki KD, Kemper HCG, Makgae PJ (2005). The association of fat patterning with blood pressure in rural South African children: the Ellisras Longitudinal Growth and Health Study. Int J Epidemiol, 35 (1): 114-20.
Makgae PJ, Monyeki KD, Brits JS, Kemper HCG, Mashita J. Somatotype and blood pres-sure of rural South African children aged 9-13 years: Ellisras Longitudinal Growth and Health Study. Ann Hum Biol, 2007; 34 (4): 240-51.
Xi B, Zhang T, Zhang M, Liu F, Zong X, ZhaoM et al. Trends in Elevated Blood Pressure Among US Children and Adolescents: 1999±2012. Am J Hypertens. 2016; 29 (2): 217±25. doi: 10.1093/ajh/hpv091PMID: 26158854.
Goma F M, Nzala S H, Babaniyi O, Songolo P, Zyaambo C, Rudatsikira E, Siziya S, and Muula AS.: Prevalence of hypertension and its correlates in Lusaka urban district of Zambia: a population based survey. Int Arch Med. 2011; 4: 34.
Mostswagole BS, Kruger HS, Faber M, Van Rooyen JM, De Ridder JH. The sensitivity of waist-to-height ration in identify-ing children with high blood pressure. CVJ Africa, 2011; 22 (4): 208-11.
Mkhonto SS, Mabaso MLH. Relationship between obesity and blood pressure in school-going adolescents in Limpopo Province of South Africa. J Obes Res Clin Pract, 2012; doi: 10.1016/j.orcp.2012.02.001
Nur N, Cetinkaya S, Yilmaz A, Ayvaz A, Bulut MO, Sumer H. Prevalence of hypertension among high school students in a middle Anatolian Province of Turkey. Health Popul Nutr 2008; 26: 88-94.
Kollias A, Antonodimitrakis P, Grammatikos E, Chatziantonakis N, Grammatikos EE, Ster-giou GS. Trends in high blood pressure prevalence in Greek adolescents. J Hum Hyper-tens, 2009; 23 (6): 385-90.
Shahid A, Ramzan A, Mustufa MA, Nasim S, Pir-zada AG. Blood pressure, body mass index and waist circumference of school going children of Karachi. Pak J Med Res, 2010; 49 (4): 116-20.
Aounallah-Skhiri H, El Ati J, Traissac P, Romd-hane HB, Eymard-Duvernay S, Delpeuch F, et al. Blood pressure and associated fac-tors in a North African adolescent population. A national cross-sectional study in Tunisia. BMC Publ Health. 2012; 12: 98.
Tirosh A, Afek A, Rudich A, Percik R, Gordon B, Ayalon N, et al.. Progression of normotensive adolescents to hypertensive adults: a study of 26,980 teenagers. J Hypertens, 2010; 56 (2): 203-9.
Zardast M, Namakin K, Taheri F, et al. Prevalence of high blood pressure in primary school children in Birjand-Iran. Journal of Birjand University of Medical Sciences. 2013; 19: 61–8.
Falah A, Gachkar L, Faraji S. Evaluation of blood pressure in school children 11-7 years in Tehran in 2003. Journal of Zanjan University of Medical Sciences. 2003; 11: 43–8.
Krishna P, Bajaj S, Thennarasu K, Desai N, Prasammakumar KM. Regional differences in the reference blood pressure in young Indians. Indian Pediatr 2007; 44: 921-923.
Wolf-Maier K, Cooper RS, Banegas JR, Giampaoli S, Hense HW, Joffres M. Hypertension prevalence and blood pressure levels in 6 European countries, Canada, and the United States. JAMA 2003; 289: 2363-2369.
Lei S, S-Yong YX, Xiao-Han D, Chang-Sheng C. Geographical differences in blood pressure of male youth aged 17-21 years in China. Blood Press 2004; 13: 169-175.
Abdulle A, Al-Junaibi A, Nagelkerke N. High blood pressure and its association with body weight among children and adoles¬cents in the United Arab Emirates. PLoS One. 2014; 9 (1): e85129.
Pate RR, Mclver K, Dowda M, Brown WH, Addy C. Directly observed physical activity levels in preschool children. J Sch Health. 2008; 78 (8): 438-44.
Manu R, Sundaram KR, Paul M, Deepa AS, Ku-mar RK. Obesity in Indian children: time trends and relationships with hyperten-sion. Natl Med J India, 2007; 20 (6): 288-93.
Taksande A, Chaturvedi P, Vilhekar K, Jain M. Distribution of blood pressure in school children in rural area of Wardha Dis-trict, Maharashtra, India. Ann Paediatr Card. 2008; 1 (2): 101-6.
Flores-Huerta S, Klunder-Klunder M, Reyes DIC, Santos JI. Increase in body mass index and waist circumference is associated with high blood pressure in children and adolescents in Mexico City. Arch Med Res, 2009; 40 (3): 208-13.
Sorof JM, Lai D, Turner J, Poffenbarger T, Portman RJ. Overweight, ethnicity, and the prevalence of hypertension in school-aged children. Pediatrics. 2004; 113: 475±82. PMID: 14993537.
Riley M, Bluhm B. High blood pressure in children and adolescents. American Family Physician. 2012; 85: 693–700.
National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents Pediatrics 2004; 114; 555 /content/114/Supplement_2/555.full.html#ref-list-1
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