A Follow-up Study on Hypertensive Children and Adolescents among Childhood Urine Screening Positives in Taiwan
Date Issued
2009
Date
2009
Author(s)
Liao, Chien-Chang
Abstract
Hypertension is one of common chronic diseases and an important risk factor of cardiovascular disease. With the increasing prevalence of childhood obesity, the childhood hypertension is increasing as well. Early detection and control of hypertension for children and adolescent may help to prevent the adulthood hypertension and other cardiovascular diseases. Blood pressure measurement is not included in the regular health checkup for school children and there are limited studies on hypertension in children and adolescents. This study is to investigate factors associated with childhood hypertension using data obtained from a mass urine screening campaign among school children in Taiwan Province, 1992-2000. We also conducted a follow-up study among children with hypertension to investigate the impact of childhood hypertension on the early adulthood health, 10 years after the screening campaign, especially the cardiovascular metabolic abnormalities.his study therefore consists of two projects: (1) The first study is a case-control study. We identified school children with urine screening positive in the 1992-2000 campaign. We used the childhood hypertension criteria of American National High Blood Pressure Education Program Working Group to determine hypertensive cases. The available information included anthropometrics, measurement of blood pressure, and selected biochemicals. We selected non-hypertensive children also from urine screening positive children as controls, frequency matched by age and sex to conduct nested case-control analyses for risks associated with childhood hypertension. (2) The second part of study is a follow-up study. Urine screening positive students who lived in Taipei and Taichung were invited for a follow-up health examination including questionnaire interviews, anthropometric measures and blood pressure, blood tests, urine screenings, and exams of atherosclerosis. In this prospective cohort study, we considered those hypertensive children identified from the mass urine screening campaign as exposed group and non-hypertensive students as non-exposed controls for comparison.n the case-control study we found: (1) The prevalence of obesity in cases was three times higher than that in controls (17.9% vs. 6.1%, p <0.0001). The multivariate logistic regression showed that the strongest risk for childhood hypertension was associated with obesity (OR = 3.45, 95% CI = 3.20-3.72). High cholesterol was also a factor associated with childhood hypertension. Both factors had the dose-response relationship with hypertension (p <0.0001). (2) A V-shape relationship was found between birth weight and hypertension risk. Among non-obese children, those with higher birth weight (OR = 1.19, 95% CI = 1.05-1.34) or low birth weight (OR = 1.1, 95% CI = 0.96-1.27) had higher risk of hypertension compared with children with the weight of 2500-2999 gram. (3)Compared with children with the lowest IgA decile, children with the highest IgA decile had higher risks for hypertension (OR = 1.20, 95% CI = 1.08-1.34), hypercholesterol (OR = 1.22, 95% CI = 1.11-1.34), and impaired fasting glucose (OR = 1.77, 95% CI = 1.62-1.93). The risk of impaired fasting glucose increased to 2.93 (95% CI = 1.93-4.44) among obese children with the highest decile of IgA. n the follow-up study, those with childhood hypertension at the baseline remained at a high risk of hypertensive than children without childhood hypertension (OR = 4.19, 95% CI = 2.42-7.28). They were also at higher risks of impaired fasting glucose (OR = 4.70, 95% CI = 1.62-13.6), and developing metabolic syndrome (OR = 4.20, 95% CI = 1.23-14.3).his study shows that obesity is the significant risk factor of hypertension for children and adolescents. High levels of IgA and birth weight are also associated with childhood hypertension. Childhood hypertension increases the risk of remaining hypertension and developing metabolic abnormalities later in young adulthood.
Subjects
Hypertension
Children and adolescents
Obesity
Birth weight
Immunoglobulin A
Follow-up
Cardiovascular metabolic abnormalities
SDGs
Type
thesis
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