title: Blood pressure and its associated factors among primary school children in suburban Selangor, Malaysia: A cross-sectional survey.
abstract: BACKGROUND
  Little is known about the relationship of blood pressure (BP) with adiposity indicators, dietary habits, physical activity, and sleep in school children in Malaysia. We aimed to study about the distribution of BP and its associated factors in primary school children.
  
  
  METHODS
  A survey was carried out on a random sample of 335 children in five primary schools. BP was measured with a mercury sphygmomanometer. Anthropometry was done by standard methods. Demographic information, dietary habits, physical activity, and duration of sleep were collected by interviews. World Health Organization classification based on body mass index (BMI) and waist circumference (WC) cut-offs were used to define overweight/obesity. Elevated BP was defined according to US reference standards.
  
  
  RESULTS
  A total 335 children (144 boys and 191 girls) were examined. Their mean age was 9.18 years (standard deviation [SD] = 0.28). Overall mean systolic blood pressure (SBP) and mean diastolic blood pressure (DBP) were 99.32 mmHg (SD = 10.79) and 67.11 mmHg (SD = 10.76), respectively. Mean BMI and WC were 16.39 (SD = 3.58) and 57.77 cm (SD = 8.98), respectively. The prevalence of pre-hypertension was 12.23% (95% confidence intervals [CIs] 8.73, 15.75) and hypertension was 13.4% (95% CIs 9.78, 17.09). Mean SBP and DBP was higher among overweight and obese children than normal children. By multivariate linear regression analyses, BMI (β = 0.250, P = 0.049) and WC (β = 0.308, P = 0.015) were positively associated with SBP; age (β = 0.111, P = 0.017), BMI (β = 0.320, P = 0.012) were positively associated with DBP but total (weekly) hours of sleep (β = -0.095, P = 0.037) was negatively associated with DBP.
  
  
  CONCLUSIONS
  BP was associated with BMI and WC. Health promotion activities should be initiated in primary schools.
authors: Departments of Clinical Sciences, Faculty of Medicine and Health Sciences, University Tunku Abdul Rahman, Sungai Long, Selangor, Malaysia.
authors: Chandrashekhar T
authors: CT
authors: Sreeramareddy
authors: Wai F
authors: WF
authors: Chew
authors: Veronica
authors: V
authors: Poulsaeman
authors: Nem Y
authors: NY
authors: Boo
authors: Kong B
authors: KB
authors: Choo
authors: Sook F
authors: SF
authors: Yap
keywords: Blood pressure; body mass index; cross-sectional survey; obesity; school children; waist circumference
references: Indian J Pediatr. 2012 Sep;79(9):1206-12
references: 22203427
references: Hypertension. 2007 Dec;50(6):991-7
references: 17954719
references: N Engl J Med. 1998 Jun 4;338(23):1650-6
references: 9614255
references: Indian J Endocrinol Metab. 2012 Jan;16(1):13-9
references: 22276248
references: Am J Hypertens. 1995 Jul;8(7):657-65
references: 7546488
references: Public Health Nutr. 2008 Sep;11(9):905-13
references: 18005488
references: Obes Rev. 2010 Jun;11(6):403-12
references: 20233309
references: Ann Pediatr Cardiol. 2008 Jul;1(2):101-6
references: 20300250
references: Hypertension. 2006 Jul;48(1):40-4
references: 16735644
references: Hypertension. 2004 Feb;43(2):214-8
references: 14744920
references: Indian J Community Med. 2010 Jan;35(1):125-9
references: 20606936
references: Biomed Res. 2006 Jun;27(3):111-5
references: 16847356
references: Natl Med J India. 2007 Nov-Dec;20(6):288-93
references: 18335794
references: Am J Hypertens. 2002 Feb;15(2 Pt 2):57S-60S
references: 11866232
references: Malays J Nutr. 2011 Aug;17(2):151-62
references: 22303570
references: Lancet. 2006 Jul 22;368(9532):299-304
references: 16860699
references: Int J Pediatr Obes. 2011 Aug;6(3-4):229-35
references: 21668385
references: Indian Heart J. 2004 Jul-Aug;56(4):310-4
references: 15586739
references: Pediatrics. 2004 Aug;114(2 Suppl 4th Report):555-76
references: 15286277
references: Indian Pediatr. 2010 Jun;47(6):477-85
references: 19736371
references: N Engl J Med. 1992 Nov 5;327(19):1350-5
references: 1406836
references: J Hum Hypertens. 2007 Feb;21(2):120-7
references: 17136104
references: Circulation. 2003 Mar 25;107(11):1562-6
references: 12654618
references: Med J Malaysia. 2012 Apr;67(2):147-50
references: 22822632
references: J Family Community Med. 2006 May;13(2):53-4
references: 23012104
references: J Family Community Med. 1997 Jul;4(2):55-63
references: 23008574
references: Asia Pac J Clin Nutr. 2001;10(2):76-80
references: 11710361
references: Pediatrics. 2004 Mar;113(3 Pt 1):475-82
references: 14993537
references: Malays J Nutr. 2011 Apr;17(1):87-95
references: 22135868
references: Food Nutr Bull. 2002 Mar;23(1):41-7
references: 11975368
references: J Hypertens. 2002 Feb;20(2):195-202
references: 11821703
references: Hypertension. 2000 Aug;36(2):165-70
references: 10948072
references: Lancet. 2002 Aug 10;360(9331):473-82
references: 12241736
references: J Pediatr. 2003 Dec;143(6):720-4
references: 14657815
references: Bull World Health Organ. 2007 Sep;85(9):660-7
references: 18026621
references: J Am Coll Cardiol. 2009 Dec 15;54(25):2396-406
references: 20082930
references: Trop Biomed. 2006 Dec;23(2):148-54
references: 17322816
references: J Hum Hypertens. 2010 Oct;24(10):652-8
references: 20147972
references: Nutr Metab Cardiovasc Dis. 2006 May;16(4):239-48
references: 16679215
references: Hypertension. 2002 Oct;40(4):441-7
references: 12364344
references: Prev Med. 2009 Jun;48(6):543-8
references: 19286003
references: Eur J Clin Nutr. 2007 May;61(5):633-41
references: 17136039
references: Pediatrics. 2007 Mar;119(3):544-53
references: 17332208
references: Pediatr Cardiol. 2009 Apr;30(3):248-55
references: 19020793
references: J Hum Hypertens. 2006 Jul;20(7):546-8
references: 16617308
references: Am J Public Health. 1992 Mar;82(3):358-63
references: 1536350