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Contribution of behavioral risk factors in the implementation of arterial hypertension in children

Modern pediatrics. Ukraine. 2019.5(101):49-56; doi 10.15574/SP.2019.101.49
Nelea Matraguna, Lilia Bichir-Thoreac, Svetlana Cojocari
Cardiological Institute, Chisinau, Republic of Moldova

For citation: Matraguna N, Bichir-Thoreac LN, Cojocari S. (2019). Contribution of behavioral risk factors in the implementation of arterial hypertensionin children. Modern Pediatrics.Ukraine. 5(101): 49-56. doi 10.15574/SP.2019.101.49
Article received: Apr 16, 2019. Accepted for publication: Sep 18, 2019.

Unhealthy diet, hypodynamia and obesity have contributed to increasing the prevalence of essential HT in children. Chronic stress, alcohol and long-term smoking have been attributed only to the adult's pathologies, but lately there is a growing concern regarding the increasing exposure of the pediatric population to these factors.
Purpose: Estimation of behavioral risk factors impact in reaching high blood pressure in children.
Materials and Methods. The study included 115 hypertensive children between 10 and 18 years. Depending on their BMI, three research groups were created: group I — 35 normal weight hypertensive children (HT, NW), group II — 36 overweight hypertensive children (HT, OW) and group III — 44 obese hypertensive children (HT, OB). A list of specific aspects were analyzed: family and child adverses, family nutrition culture, sedentarism level, and the influence of chronic family and social stress, according to a survey specially elaborated.
Results. Most hypertensive children from the research, from the overweight and obese category, have a sedentary lifestyle and unbalanced diet. In these families the fatty foods are mainly consumed, as well as carbohydrates easily digestible with a high glycemic index and they also use salt in excess.
Conclusion. Behavioral risk factors can be influenced (removed or at least diminished) by a responsible attitude, which should be directed to the pediatric population that faces an increasing risk, and also is the most receptive to prevention measures that address a healthy lifestyle, with proper nutrition and sport.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee (LEC) of an institution.
No conflict of interest was declared by the authors.
Keywords: behavioral risk factors, arterial hypertension, children.

REFERENCES

1. Benson L, Baer H, Kaelber D. (2009). Trends in the diagnosis of overweight and obesity in children and adolescents: 1999–2007. Pediatrics. 123 (1): 153–158. https://doi.org/10.1542/peds.2008-1408; PMid:19117837

2. Brumana L, Arroyo A, Schwalbe NR et al. (2017). Maternal and child health services and an integrated, life-cycle approach to the prevention of NCDs. British Medical Journal of Global Health. 2:e000295. https://doi.org/10.1136/bmjgh-2017-000295; PMid:29082005 PMCid:PMC5656183

3. Costa JS, Barcellos FC, Sclowitz ML et al. (2007). Prevalencia de Hipertensao Arterial em Adultos e Fatores Associados: um Estudo de Base Populacional Urbana em Pelotas, Rio Grande do Sul, Brasil. Arq Bras Cardiol. 88(1): 54–59. https://doi.org/10.1590/S0066-782X2007000100010; PMid:17364120

4. De Oliveira-Martins S, Oliveira T, Gomes JJ et al. (2011). Factores associados a hipertensao arterial nos utentes de farmacias em Portugal. Revista de Saude Publica.45(1): 136–144. https://doi.org/10.1590/S0034-89102010005000056; PMid:21152705

5. Ferrazzo KL, Meinke GS, Silva ME et al. (Setembrooutubro de 2014). Pre-hipertensao, hipertensao arterial e fatores associados em pacientes odontologicos: estudo transversal na cidade de Santa Maria-RS, Brasil. Revista de Odontologia da UNESP.43(5): 305–313. https://doi.org/10.1590/rou.2014.049

6. Ferreira JS, Aydos RD. (2010). Prevalencia de hipertensao arterial em criancas e adolescentes obesos. Ciencia and Saude Coletiva.15(1): 97–104. https://doi.org/10.1590/S1413-81232010000100015; PMid:20169236

7. Flechtner/Mors M, Neuhauser H, Reinehr T, Roost HP, Wiegand S, Siegfried W et al. (2015). APV initiative and the BMBF Competence Network Obesity. Blood pressure in 57,915 pediatric patients who are overweight or obese based on five reference systems. Am J Cardiol. 115: 1587–1594. https://doi.org/10.1016/j.amjcard.2015.02.063; PMid:25862158

8. Genovesi S, Antolini L, Giussani M, Pieruzzi F, Galbiati S, Valsecchi MG et al. (2008). Usefulness of waist circumference for the identification of childhood hypertension. J Hypertens. 26: 1563–1570. https://doi.org/10.1097/HJH.0b013e328302842b; PMid:18622233

9. Isabel C Pinto, Debora Martins (2017). Prevalence and risk factors of arterial hypertension: A literature review. J Cardiovasc Med Ther. 1;2. http://www.alliedacademies.org/cardiovascular/medicine/therapeutics/.

10. Jennings G, Parati G. (2010). Blood pressure up in a puff of smoke. In: Journal of Hypertension. 28(9): 1806–1808. https://doi.org/10.1097/HJH.0b013e32833e0d14; PMid:20699712

11. Katona E, Zri’nyi M, Lengyel S, Komonyi E, Paragh G, Zatik J et al. (2011). The prevalence of adolescent hypertension in Hungary – the Debrecen hypertension study. Blood Press. 20: 134–139. https://doi.org/10.3109/08037051.2010.538987; PMid:21133825

12. Martinez/Gomez D, Tucker J, Heelan K et al. (2009). Associations between sedentary behavior and blood pressure in young children. Arch Pediatr Adolesc Med. 163(8): 724–730. https://doi.org/10.1001/archpediatrics.2009.90; PMid:19652104

13. Moura IH, Silva GR, Silva AR et al. (2015). Prevalencia de hipertensao arterial e seus fatores de risco em adolescentes. Acta Paulista de Enfermagem.28(1): 81–86. https://doi.org/10.1590/1982-0194201500014

14. NCD Risk Factor Collaboration (NCD/RisC). (2017, Dec 16). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults. Lancet. 390(10113): 2627–2642. https://doi.org/10.1016/S0140-6736(17)32129-3

15. NCD Risk Factor Collaboration. (2017). Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 populationbased measurement studies with 19·1 million participants. Lancet. 389: 37–55.

16. Oberg M, Jaakkola MS, Woodward A et al. (2011). Worldwide burden of disease from exposure to second/hand smoke: a retrospective analysis of data from 192 countries. Lancet. 377: 139–46. https://doi.org/10.1016/S0140-6736(10)61388-8

17. Pastucha D, Talafa V, Jana Malincikovaaet al. (2010, Mar). Obesity, hypertension and insulin resistance in childhood – a pilot study. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 154(1): 77–82. https://doi.org/10.5507/bp.2010.013

18. Ribeiro MJ, Oliveira TC, Salgado Filho N et al. (2009). Prevalencia do Hiperaldosteronismo Primario em uma Liga de Hipertensao Arterial Sistemica. Arquivos Brasileiros de Cardiologia.92(1): 39–45. https://doi.org/10.1590/S0066-782X2009000100007; PMid:19219263

19. Sorof JM, Lai D, Turner J, Poffenbarger T, Portman RJ. (2004). Overweight, ethnicity, and the prevalence of hypertension in school-aged children. Pediatrics. 113: 475–482. https://doi.org/10.1542/peds.113.3.475; PMid:14993537

20. Ulbrich AZ, Stabelini Neto A, Bertin RL et al. (2011). Associacao do estado nutricional com a hipertensao arterial de adultos. Motriz rev educ fis (Imp.).17(3): 424–430. https://doi.org/10.1590/S1980-65742011000300006

21. WHO. (2014). Global status report on alcohol and health. Geneva: WHO.

22. WHO. (2014). Global status report on noncommunicable disease 2014. Geneva: World Health Organization.

23. WHO. (2014). Health for the world's adolescents. A second chance in the second decade. Geneva: WHO.

24. WHO. (2017). Report on the global tobacco epidemic, 2017: Monitoring tobacco use and prevention policies. Geneva: WHO.

25. Xi B, Liang Y, Liu Y et al. (2016, Nov). Tobacco use and second-hand smoke exposure in young adolescents aged 12–15 years: data from 68 low-income and middle-income countries. Lancet Glob Health.4(11): e795/e805. https://doi.org/10.1016/S2214-109X(16)30187-5.

26. Zhang YJ, Wang YO, Li L, Guo JJ, Wang JB. (2011, Aug 27). China's first rare-disease registry is under development. Lancet.378(9793): 769–70. https://doi.org/10.1016/S0140-6736(11)61375-5