Blood pressure and body mass index in an ethnically diverse sample of adolescents in Paramaribo, Suriname.
BACKGROUND
High blood pressure (BP) is now an important public health problem in non-industrialised countries. The limited evidence suggests ethnic inequalities in BP in adults in some non-industrialised countries. However, it is unclear whether these ethnic inequalities in BP patterns in adults reflect on adolescents. Hence, we assessed ethnic differences in BP, and the association of BP with body mass index (BMI) among adolescents aged 12-17 years in Paramaribo, Suriname.


METHODS
Cross-sectional study with anthropometric and blood pressure measurements. A random sample of 855 adolescents (167 Hindustanis, 169 Creoles, 128 Javanese, 91 Maroons and 300 mixed-ethnicities) were studied. Ethnicity was based on self-reported ethnic origin.


RESULTS
Among boys, Maroons had a lower age- and height-adjusted systolic BP than Creoles, and a lower diastolic BP than other ethnic groups. However, after further adjustment for BMI, only diastolic BP in Maroons was significantly lower than in Javanese (67.1 versus 70.9 mmHg). Creole boys had a lower diastolic BP than Hindustani (67.3 versus 70.2 mmHg) and Javanese boys after adjustment for age, height and BMI. Among girls, there were no significant differences in systolic BP between the ethnic groups. Maroon girls, however, had a lower diastolic BP (65.6 mmHg) than Hindustani (69.1 mmHg), Javanese (71.2 mmHg) and Mixed-ethnic (68.3 mmHg) girls, but only after differences in BMI had been adjusted for. Javanese had a higher diastolic BP than Creoles (71.2 versus 66.8 mmHg) and Mixed-ethnicity girls. BMI was positively associated with BP in all the ethnic groups, except for diastolic BP in Maroon girls.


CONCLUSIONS
The study findings indicate higher mean BP levels among Javanese and Hindustani adolescents compared with their African descent peers. These findings contrast the relatively low BP reported in Javanese and Hindustani adult populations in Suriname and underscore the need for public health measures early in life to prevent high BP and its sequelae in later life.
Agyemang
Charles
C
Department of Social Medicine, Academic Medical Centre, Amsterdam, The Netherlands. c.o.agyemang@amc.uva.nl
Oudeman
Eline
E
Zijlmans
Wilco
W
Wendte
Johannes
J
Stronks
Karien
K
D000293:Adolescent; D000367:Age Factors; D001794:Blood Pressure; D015992:Body Mass Index; D002648:Child; D003430:Cross-Sectional Studies; D018864:Cultural Diversity; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology* / Q000517:prevention & control; D044382:Population Groups / Q000208:ethnology*; D012737:Sex Factors; D013532:Suriname / Q000453:epidemiology / Q000208:ethnology