title: Prevalence and risk factors for hypertension in Hong Kong Chinese adolescents: waist circumference predicts hypertension, exercise decreases risk.
abstract: OBJECTIVE
  To determine the prevalence, risk factors for and patterns of hypertension in Chinese adolescents based on a territory-wide school based screening programme in Hong Kong.
  
  
  METHODS
  Cross-sectional anthropometric and oscillometric blood pressure (BP) measurements and lifestyle information were obtained as part of a growth survey of students from randomly selected secondary schools in Hong Kong. Those with blood pressure ≥ 95th centile were screened a second or third time. Hypertension is defined as elevated blood pressure on three separate occasions. The independent effects of age, sex, body mass index, high waist circumference (≥ 85th centile), sleep duration, family history of hypertension and frequency of exercise on hypertension were explored by multivariate analysis.
  
  
  RESULTS
  Among the 6193 students screened, the prevalence of elevated blood pressure on the first, second and third screens was 9.54%, 2.77% and 1.44% respectively. Hypertension was more likely to be systolic. High waist circumference (≥ 85th centile) was independently associated with a higher risk of hypertension (adjusted OR 2.4), while exercising twice or more per week was protective (adjusted OR 0.28).
  
  
  CONCLUSIONS
  The prevalence of hypertension in Hong Kong Chinese adolescents is 1.44%. The current study shows high waist circumference is a predictor of hypertension in adolescents, while increased physical activity is a protective factor. Incorporating waist circumference into screening protocols may increase the sensitivity of cardiovascular risk stratification. Healthcare providers should be strong advocates helping to prevent obesity and promote physical activity in adolescents and children.
authors.affiliation: Department of Paediatrics, Kwong Wah Hospital, 25 Waterloo Road, Kowloon, Hong Kong, China. leungckl@ha.org.hk
authors.forename: Lettie C K
authors.initials: LC
authors.lastname: Leung
authors.forename: Rita Y T
authors.initials: RY
authors.lastname: Sung
authors.forename: Hung-Kwan
authors.initials: HK
authors.lastname: So
authors.forename: Sik Nin
authors.initials: SN
authors.lastname: Wong
authors.forename: Kwok Wai
authors.initials: KW
authors.lastname: Lee
authors.forename: Kwok Piu
authors.initials: KP
authors.lastname: Lee
authors.forename: Man Ching
authors.initials: MC
authors.lastname: Yam
authors.forename: Samantha P S
authors.initials: SP
authors.lastname: Li
authors.forename: So Fun
authors.initials: SF
authors.lastname: Yuen
authors.forename: Stella
authors.initials: S
authors.lastname: Chim
authors.forename: Keung Kit
authors.initials: KK
authors.lastname: Chan
authors.forename: David
authors.initials: D
authors.lastname: Luk
mesh_terms: D000293:Adolescent; D000886:Anthropometry / Q000379:methods; D002648:Child; D004812:Epidemiologic Methods; D015444:Exercise / Q000502:physiology*; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D008019:Life Style; D008297:Male; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D009991:Oscillometry / Q000379:methods; D012307:Risk Factors; D055105:Waist Circumference