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Licensed Unlicensed Requires Authentication Published by De Gruyter July 28, 2015

Hypertension and its association with anthropometric indexes among pre-university students

  • Whye Lian Cheah EMAIL logo , Helmy Hazmi , Hui Qi Chia , Empiang Tindin , Nur Adilah Ahmad Zafri and Syarul Haziq Mohd Shah

Abstract

Hypertension has become increasingly common among adolescents. This study aimed to investigate the prevalence of hypertension and its association with anthropometric indexes among pre-university students. This was a cross-sectional study carried out among pre-university students of a public university. Anthropometric measurements were conducted using mobile stadiometers, digital body fat scales and measuring tapes. Body fat percentage was measured with a body composition analyzer, and blood pressure was determined using digital blood pressure monitors. Statistical analyses were done using Statistical Package for Social Sciences (SPSS) Statistics 20. A total of 218 respondents participated in the study. The prevalence of hypertension at risk was 7.3%, which was higher among males (16.7%). About 22% of the respondents were overweight and obese. The majority of males had a normal waist circumference (WC) (75.9%), but almost half of females had a WC value in the unhealthy category (47.0%). Females had higher conicity indexes and body fat compared to males. Respondents who were found to have hypertension at risk had a higher prevalence of being overweight and having unhealthy WC and waist-to-height ratio and had high conicity indexes and a high percentage of fat. Risk factors independently associated with hypertension at risk included male gender (odds ratio=4.213, 95% CI, 1.238–14.342) and body mass index (odds ratio=7.865, 95% CI, 1.165–53.099). Regular screening of hypertension at risk among adolescents and initiation of early treatment for those affected should be conducted to avoid further complication in later life.

  1. Conflict of interest statement: None.

References

1. Norfazilah A, Samuel A, Law PT, Ainaa A, Nurul A, et al. Illness perception among hypertensive patients in primary care centre UKMMC. Malays Fam Physician 2013;8:19–25.Search in Google Scholar

2. Ministry of Health Malaysia, Academy of Medicine of Malaysia, Malaysian Society of Hypertension. Clinical practice guidelines on management of hypertension, 4th ed. Available at: http://www.acadmed.org.my/index.cfm?&menuid=67. Accessed on April 24, 2014.Search in Google Scholar

3. Luma GB, Spiotta RT. Hypertension in children and adolescents. Am Fam Physician 2006;73:1558–68.Search in Google Scholar

4. Muhammad Yazid J, Aisha Fadhilah AA, Noorasekin S, Nurshadia S, Zahurin M, et al. One in five overweight/obese adolescents in the community has metabolic syndrome. J Health Transl Med 2013;16(Special Edition).Search in Google Scholar

5. Rampal L, Ng KC, Izzati IN, Izzati ZF, Nazrul IM, et al. Prevalence of hypertension among Malay adolescents in Putrajaya secondary schools, Malaysia, 2010. Malays J Med Health Sci 2011;7:53–60.Search in Google Scholar

6. Cromwell PF, Munn N, Zolkowski-Wynne J. Evaluation and management of hypertension in children and adolescents (part one): diagnosis. J Pediatr Health Care 2005;19:172–5.10.1016/j.pedhc.2005.02.005Search in Google Scholar PubMed

7. Daniels SR. Hypertension-induced cardiac damage in children and adolescents. Blood Press Monitor 1999;4:165–70.Search in Google Scholar

8. Thompson M, Dana T, Bougatsos C, Blazina I, Norris SL. Screening for hypertension in children and adolescents to prevent cardiovascular disease. Pediatrics 2013;131:490–525.10.1542/peds.2012-3523Search in Google Scholar PubMed

9. Schiel R, Beltschikow W, Kramer G, Stein G. Overweight, obesity and elevated blood pressure in children and adolescents. Eur J Med Res 2006;11:97–101.Search in Google Scholar

10. Lee P. Malaysia is fattest country in South-East Asia. The Star Online. 2014. Available at: http://www.thestar.com.my/News/Nation/2014/01/16/Scoring-badly-on-dietary-habits-Malaysia-is-fattest-country-in-SE-Asia/. Accessed on April 24, 2014.Search in Google Scholar

11. Stabouli S, Kotsis V, Papamichael C, Constantopoulos A, Zakopoulos N. Adolescent obesity is associated with high ambulatory blood pressure and increased carotid intimal-medial thickness. J Pediatr 2005;147:651–6.10.1016/j.jpeds.2005.06.008Search in Google Scholar PubMed

12. Suglia SF, Clark CJ, Gary-Webb TL. Adolescent obesity, change in weight status, and hypertension: racial/ethnic variations. Hypertension 2013;61:290–5.10.1161/HYPERTENSIONAHA.111.00214Search in Google Scholar PubMed PubMed Central

13. Cheng N. Malaysia is now the fattest country in SE Asia, says Liow. The Star. 2013. Available at: http://www.thestar.com.my/News/Nation/2013/01/18/Malaysia-is-now-the-fattest-country-in-SE-Asia-says-Liow.aspx. Accessed on April 24, 2014.Search in Google Scholar

14. Mizrahi-Lehrer E, Cepeda-Valery B, Romero-Corral A. Anthropometry of body fat: how anthropometric measures predict mortality and especially cardiovascular mortality. In: Preedy VR, editor. Handbook of Anthropometry. New York: Springer, 2012:385–95.10.1007/978-1-4419-1788-1_21Search in Google Scholar

15. Bastien M, Poirier P, Lemieux I, Després JP. Overview of epidemiology and contribution of obesity to cardiovascular disease. Prog Cardiovasc Dis 2014;56:369–81.10.1016/j.pcad.2013.10.016Search in Google Scholar PubMed

16. Direk K, Cecelja M, Astle W, Chowienczyk P, Spector TD, et al. The relationship between DXA-based and anthropometric measures of visceral fat and morbidity in women. BMC Cardiovasc Disord 2013;13:25.10.1186/1471-2261-13-25Search in Google Scholar PubMed PubMed Central

17. Pereira PF, Serrano H, Carvalho GQ, Lamounier JA, Peluzio MDCG, et al. Body fat location and cardiovascular disease risk factors in overweight female adolescents and eutrophic female adolescents with a high percentage of body fat. Cardiol Young 2012;22:162–9.10.1017/S1047951111001430Search in Google Scholar PubMed

18. Cândido AP, Freitas SN, Machado-Coelho GL. Anthropometric measurements and obesity diagnosis in schoolchildren. Acta Paediatr 2011;100:e120–4.10.1111/j.1651-2227.2011.02296.xSearch in Google Scholar PubMed

19. Pérez DJA, Verdalles-Guzmán U, Abad S, Vega A, Reque J, et al. Metabolic syndrome is associated with cardiovascular events in haemodialysis. Nefrologia 2014;34:69–75.Search in Google Scholar

20. Silva DAS, Petroski EL, Peres MA. Accuracy and measures of association of anthropometric indexes of obesity to identify the presence of hypertension in adults: a population-based study in Southern Brazil. Eur J Nutr 2013;52:237–46.10.1007/s00394-012-0314-8Search in Google Scholar PubMed

21. Janssen I, Katzmarzyk PT, Ross R. Body mass index, waist circumference, and health risk: evidence in support of current National Institutes of Health guidelines. Arch Intern Med 2002;162:2074–9.10.1001/archinte.162.18.2074Search in Google Scholar

22. McCarthy HD, Ashwell M. A study of central fatness using waist-to-height ratios in UK children and adolescents over two decades supports the simple message–‘keep your waist circumference to less than half your height’. Int J Obes 2006;30:988–92.10.1038/sj.ijo.0803226Search in Google Scholar

23. Yan W, Bingxian H, Hua Y, Jianghong D, Jun C, et al. Waist-to-height ratio is an accurate and easier index for evaluating obesity in children and adolescents. Obesity 2007;15:748–52.10.1038/oby.2007.601Search in Google Scholar

24. Maffeis C, Banzato C, Talamini G. Waist-to-height ratio, a useful index to identify high metabolic risk in overweight children. J Pediatr 2008;152:207–13.10.1016/j.jpeds.2007.09.021Search in Google Scholar

25. Li WC, Chen IC, Chang YC, Loke SS, Wang SH, et al. Waist-to-height ratio, waist circumference, and body mass index as indices of cardiometabolic risk among 36,642 Taiwanese adults. Eur J Nutr 2013;52:57–65.10.1007/s00394-011-0286-0Search in Google Scholar

26. Onis MD, Onyango AW, Borghi E, Siyam A, Nishida C, et al. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ 2007;85:660–7.10.2471/BLT.07.043497Search in Google Scholar

27. World Health Organization. BMI-for-age (5–19 years). Available at: http://www.who.int/growthref/who2007_bmi_for_age/en/. Accessed on April 25, 2014.Search in Google Scholar

28. Beck CC, Lopes ADS, Pitanga FJG. Anthropometric indicators as predictors of high blood pressure in adolescents. Arq Bras Cardiol 2011;96:126–33.10.1590/S0066-782X2010005000153Search in Google Scholar

29. Gallagher D, Visser M, Sepulveda D, Pierson RN, Harris T, et al. How useful is body mass index for comparison of body fatness across age, sex, and ethnic groups? Am J Epidemiol 1996;143:228–39.10.1093/oxfordjournals.aje.a008733Search in Google Scholar

30. Koh KK. Effects of estrogen on the vascular wall: vasomotor function and inflammation. Cardiovasc Res 2002;55:714–26.10.1016/S0008-6363(02)00487-XSearch in Google Scholar

31. Reckelhoff JF. Gender differences in the regulation of blood pressure. Hypertension 2001;37:1199–208.10.1161/01.HYP.37.5.1199Search in Google Scholar PubMed

32. Ma J, Wang Z, Dong B, Song Y, Hu P, et al. Quantifying the relationships of blood pressure with weight, height and body mass index in Chinese children and adolescents. J Paediatr Child Health 2012;48:413–8.10.1111/j.1440-1754.2011.02221.xSearch in Google Scholar PubMed

33. Poh BK, Jannah AN, Chong LK, Ruzita AT, Ismail M, et al. Waist circumference percentile curves for Malaysian children and adolescents aged 6.0–16.9 years. Int J Pediatr Obes 2011;6:229–35.10.3109/17477166.2011.583658Search in Google Scholar PubMed

34. Schröder H, Ribas L, Koebnick C, Funtikova A, Gomez SF, et al. Prevalence of abdominal obesity in Spanish children and adolescents. Do we need waist circumference measurements in pediatric practice? PloS One 2014;9:e87549.10.1371/journal.pone.0087549Search in Google Scholar PubMed PubMed Central

35. Ying-Xiu Z, Ya-Lin L, Jin-Shan Z, Zun-Hua C, Jing-Yang Z. Distributions of waist circumference and waist-to-height ratio for children and adolescents in Shandong, China. Eur J Pediatr 2013;172:185–91.10.1007/s00431-012-1862-xSearch in Google Scholar PubMed

36. Pérez B, Landaeta-Jiménez M, Vásquez M. Fat distribution in Venezuelan children and adolescents estimated by the conicity index and waist/hip ratio. Am J Hum Biol 2002;14:15–20.10.1002/ajhb.10002Search in Google Scholar PubMed

37. Power ML, Schulkin J. Sex differences in fat storage, fat metabolism, and the health risks from obesity: possible evolutionary origins. Br J Nutr 2008;99:931–40.10.1017/S0007114507853347Search in Google Scholar PubMed

38. Jeukendrup A, Gleeson M. Sport nutrition: an introduction to energy production and performance, 2nd ed. 2009. Available at: http://www.humankinetics.com/excerpts/excerpts/normal-ranges-of-body-weight-and-body-fat.Search in Google Scholar

39. Ujunwa FA, Ikefuna AN, Nwokocha ARC, Chinawa JM. Hypertension and prehypertension among adolescents in secondary schools in Enugu, South East Nigeria. Ital J Pediatr 2013;39:70.10.1186/1824-7288-39-70Search in Google Scholar PubMed PubMed Central

40. Rodriguez G, Moreno LA, Blay VA, Garagorri JM, Sarria A, et al. Body composition in adolescents: measurements and metabolic aspects. Int J Obes 2004;28;54–58.10.1038/sj.ijo.0802805Search in Google Scholar PubMed

41. Burgos MS, Burgos LT, Camargo MD, Franke SIR, Pra D, et al. Relationship between anthropometric measures and cardiovascular risk factors in children and adolescents. Arq Bras Cardiol 2013;101:288–96.10.5935/abc.20130169Search in Google Scholar PubMed PubMed Central

42. Kalker U, Hovels O, Kolbe-Saborowski H. Obese children and adolescents. Waist-hip ratio and cardiovascular risk. Monatsschr Kinderheikd 1993;141:36–41.Search in Google Scholar

43. Hill JO, Sidney S, Lewis CE, Tolan K, Scherzinger AL, et al. Racial differences in amounts of visceral adipose tissue in young adults: the CARDIA (Coronary Artery Risk Development in Young Adults) Study. Am J Clin Nutr 1999;69:381–7.10.1093/ajcn/69.3.381Search in Google Scholar PubMed

Received: 2015-3-13
Accepted: 2015-5-11
Published Online: 2015-7-28
Published in Print: 2016-11-1

©2016 Walter de Gruyter GmbH, Berlin/Boston

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