title: Blood pressure among rural Montenegrin children in relation to poverty and gender.
abstract: BACKGROUND
  Health inequalities may begin during childhood. The aim of this study was to investigate the main effect of poverty and its interactive effect with gender on children's blood pressure.
  
  
  METHODS
  The study was performed in two elementary schools from a rural region near Podgorica, the capital of Montenegro. A questionnaire including questions on family monthly income, children's physical activity and the consumption of junk food was self-administered by parents of 434 children (223 boys and 211 girls) aged 6-13 years. Children's poverty level was assessed using the recommendations from the National Study on Poverty in Montenegro. Children's body weight and height were measured and body mass index-for-gender-and-age percentile was calculated. An oscillometric monitor was used for measurement of children's resting blood pressure in school.
  
  
  RESULTS
  A two-factorial analysis of variance with body mass index percentile, physical activity and junk food as covariates showed an interaction of gender and poverty on children's blood pressure, pointing to synergy between poverty and female gender, with statistical significance for raised diastolic pressure (F = 5.462; P = 0.021). Neither physical activity nor the consumption of junk food explained the interactive effect of poverty and gender on blood pressure.
  
  
  CONCLUSIONS
  We show that poverty is linked to elevated blood pressure for girls but not boys, and this effect is statistically significant for diastolic pressure. The results are discussed in the light of gender differences in stress and coping that are endemic to poverty.
authors.affiliation: 1 Medical Faculty, Department for Pathophysiology and Laboratory Medicine, University of Montenegro, Podgorica, Montenegro.
authors.forename: Milica
authors.initials: M
authors.lastname: Martinovic
authors.affiliation: 2 Faculty of Medicine, Institute of Hygiene and Medical Ecology, University of Belgrade, Belgrade, Serbia goran.belojevic@hotmail.com.
authors.forename: Goran
authors.initials: G
authors.lastname: Belojevic
authors.affiliation: 3 Department of Design and Environmental Analysis, Bronfenbrenner Center for Translational Research, Cornell University, Ithaca, NY, USA4 Department of Human Development, Bronfenbrenner Center for Translational Research, Cornell University, Ithaca, NY, USA.
authors.forename: Gary W
authors.initials: GW
authors.lastname: Evans
authors.affiliation: 5 Medical Faculty, Neurosurgery Clinic, University of Montenegro, Podgorica, Montenegro.
authors.forename: Bogdan
authors.initials: B
authors.lastname: Asanin
authors.affiliation: 6 Department of Epidemiology, Institute of Public Health of Montenegro, Podgorica, Montenegro.
authors.forename: Dragan
authors.initials: D
authors.lastname: Lausevic
authors.affiliation: 7 Medical Faculty, Department of Pharmacology, University of Montenegro, Podgorica, Montenegro.
authors.forename: Natasa Duborija
authors.initials: ND
authors.lastname: Kovacevic
authors.affiliation: 8 Clinical Centre of Montenegro, Institute for Children's Diseases, Podgorica, Montenegro.
authors.forename: Mira
authors.initials: M
authors.lastname: Samardzic
authors.affiliation: 9 Clinical Centre of Montenegro, Centre for Laboratory Diagnostics, Podgorica, Montenegro.
authors.forename: Marina
authors.initials: M
authors.lastname: Jaksic
authors.affiliation: 10 Medical Faculty, Department of Biochemistry, University of Montenegro, Podgorica, Montenegro.
authors.forename: Snezana
authors.initials: S
authors.lastname: Pantovic
mesh_terms: D000293:Adolescent; D000886:Anthropometry; D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000295:instrumentation / Q000379:methods*; D002648:Child; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D054548:Montenegro / Q000453:epidemiology; D011203:Poverty; D012424:Rural Population; D012737:Sex Factors; D011795:Surveys and Questionnaires