An approach of hypertension prevalence in a sample of 5381 Portuguese children and adolescents. The AVELEIRA registry. Hypertension in Children

Introduction. The distribution of blood pressure (BP) in children and adolescents remains relatively unknown. Thus, it is imperative to ascertain BP distribution at a young age, which constitutes the main objective of this registry. Methods. Cross-sectional assessment of BP in 5381 Portuguese children and adolescents, mean age 12.50 +/- 3.23 years (4-18 years), body mass index (BMI) 19.65 +/- 4.00 kg/m(2) (9.37-60.30 kg/m(2)), mostly male (4519), mean age 12.70 +/- 3.16 years, and with 862 females, mean age 11.44 +/- 3.34 years. BP and heart rate were measured three times after a 10-min resting period, with a validated automatic blood pressure monitor (OMRON 705IT) and an appropriately sized cuff over the brachial artery. About 30% of the youngsters were amateur registered athletes and 70% were beginning their sportive activity at the time of evaluation. Results. BP distribution was 12.8% stage 1 hypertension, 21.6% high-normal, and 65.6% normal (similar between genders). Registered athletes and subjects beginning their sports activity revealed different hypertension prevalence (9.8% vs 14.3%, respectively; p < 0.0001). Overweight was found in 7.8%. Hypertension and high-normal BP increased with increasing BMI. Body weight classification was independently associated with hypertension and high-normal BP. Registered sportive practice was independently associated with a reduction in hypertension prevalence. Conclusions. The proportion of children with BP above the 90th percentile was high, with an overall prevalence of hypertension of 12.8%, independent of gender and related to overweight. The implications of these observations are even more important when we consider the epidemiology of hypertension in Portugal and its link with stroke as the leading cause of death and disability.