title: Incidence of high blood pressure in children - effects of physical activity and sedentary behaviors: the IDEFICS study: High blood pressure, lifestyle and children.
abstract: OBJECTIVE
  High blood pressure (HBP) is one of the most important risk factors for cardiovascular diseases and it has a high prevalence in pediatric populations. However, the determinants of the incidence of Pre-HBP and HBP in children are not well known. i) To describe the incidence of HBP in European children; and ii) to evaluate the effect of physical activity (PA) and sedentary behavior (SB) on the Pre-HBP and HBP.
  
  
  METHODS
  The IDEFICS cohort study. A total of 16,228 children 2-9years at baseline were recruited by complex sampling population-based survey in eight European countries. At baseline (T0), 5221 children were selected for accelerometer measurements; 5061 children were re-examined 2years later (T1). We estimated the incidence of Pre-HBP and HBP and evaluate the effect of PA and SB on the Pre-HBP and HBP, by computing relative risks and the corresponding 95% confidence intervals (RR, 95% CI).
  
  
  RESULTS
  Incidences of Pre-HBP and HBP per year were: 121/1000 children and 110/1000 children, respectively. We found that children maintaining SB>2h/d during the two year follow-up showed a RR of having HBP of 1.28 (1.03-1.60). Children in T1 not performing the recommended amount of PA (<60min/d) have a RR of HBP of 1.53 (1.12 to 2.09). We found no association between pre-HBP and the behaviors.
  
  
  CONCLUSIONS
  The incidence of pre-HBP and HBP is high in European children. Maintaining sedentary behaviors during childhood increases the risk of developing HBP after two years of follow-up.
authors.affiliation: School of Medicine of the University of São Paulo, FMUSP, São Paulo, Brazil; Universidad de Zaragoza, Facultad de Ciencias de la Salud, GENUD Research Group (Growth, Exercise, Nutrition and Development) Zaragoza, Spain; YCARE (Youth/Child and Cardiovascular Risk and Environmental) Research Group, FMUSP, Brazil. Electronic address: augustocesar.demoraes@usp.br.
authors.forename: Augusto César Ferreira
authors.initials: AC
authors.lastname: de Moraes
authors.affiliation: School of Medicine of the University of São Paulo, FMUSP, São Paulo, Brazil; YCARE (Youth/Child and Cardiovascular Risk and Environmental) Research Group, FMUSP, Brazil.
authors.forename: Heráclito Barbosa
authors.initials: HB
authors.lastname: Carvalho
authors.affiliation: Unit of Epidemiology and Population Genetics, Institute of Food Sciences, National Research Council, Avellino, Italy.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Siani
authors.affiliation: Unit of Epidemiology and Population Genetics, Institute of Food Sciences, National Research Council, Avellino, Italy.
authors.forename: Gianvincenzo
authors.initials: G
authors.lastname: Barba
authors.affiliation: Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia.
authors.forename: Toomas
authors.initials: T
authors.lastname: Veidebaum
authors.affiliation: Research and Education Foundation of Child Health, Strovolos, Cyprus.
authors.forename: Michael
authors.initials: M
authors.lastname: Tornaritis
authors.affiliation: Department of Paediatrics, Medical Faculty, University of Pécs, Pécs, Hungary.
authors.forename: Denes
authors.initials: D
authors.lastname: Molnar
authors.affiliation: Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Ahrens
authors.affiliation: Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
authors.forename: Norman
authors.initials: N
authors.lastname: Wirsik
authors.affiliation: Department of Public Health, Ghent University, Ghent, Belgium.
authors.forename: Stefaan
authors.initials: S
authors.lastname: De Henauw
authors.affiliation: Department of Paediatrics, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Staffan
authors.initials: S
authors.lastname: Mårild
authors.affiliation: Department of Public Health and Community Medicine, University of Gothenburg, Sweden.
authors.forename: Lauren
authors.initials: L
authors.lastname: Lissner
authors.affiliation: Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia.
authors.forename: Kenn
authors.initials: K
authors.lastname: Konstabel
authors.affiliation: University of Glasgow, Faculty of Biomedical and Life Sciences, Glasgow, Scotland, United Kingdom.
authors.forename: Yannis
authors.initials: Y
authors.lastname: Pitsiladis
authors.affiliation: Universidad de Zaragoza, Facultad de Ciencias de la Salud, GENUD Research Group (Growth, Exercise, Nutrition and Development) Zaragoza, Spain; School of Medicine of the University of São Paulo, Department of Preventive Medicine, São Paulo, Brazil.
authors.forename: Luis A
authors.initials: LA
authors.lastname: Moreno
mesh_terms: D001794:Blood Pressure / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000209:etiology; D015994:Incidence; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D009765:Obesity / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D057185:Sedentary Behavior
keywords: Children; Cohort study; Hypertension; Lifestyle behaviors; Multicenter study