title: Understanding trends in blood pressure and their associations with body mass index in Chinese children, from 1985 to 2010: a cross-sectional observational study.
abstract: OBJECTIVE
  Understanding trends in blood pressure (BP) in childhood is crucial to addressing and reducing the burden of adulthood hypertension and associated mortality in the future. In view of growing obesity in Chinese children, we sought to investigate the trends in BP and the influence of body mass index (BMI) on them.
  
  
  METHODS
  We included 1,010,153 children aged 8-17 years, with completed records from a large national successive cross-sectional survey, the Chinese National Survey on Students' Constitution and Health, between 1985 and 2010.
  
  
  METHODS
  BP was measured according to the recommendation of the National High Blood Pressure Education Program Working Group, and the elevated BP was based on sex-, age- and height-specific 95th centile of the recommendation.
  
  
  RESULTS
  The adjusted mean systolic BP in boys and girls decreased by 3.9 and 5.6 mm Hg between 1985 and 2005, and increased by 1.3 and 1.0 mm Hg between 2005 and 2010, respectively. Corresponding adjusted prevalence of elevated systolic BP in boys and girls declined from 5.1% and 5.5% to 3.5% and 2.5% between 1985 and 2005, and increased to 4.9% and 3.5% in 2010, respectively. Adjusted mean BMI of boys and girls in 2010 was 2.0 and 1.2 kg/m(2) higher than those in 1985, respectively. The prevalence of obesity rose from 0% to 3.4% in boys and 0.9% in girls. Further adjusting for BMI did not change these trends in systolic BP. A similar pattern was also observed in diastolic BP.
  
  
  CONCLUSIONS
  After declining for 20 years, BP levels in Chinese children started to climb upwards. These trends in BP cannot be fully explained by BMI. The investigation of other determinants of BP may provide additional opportunity to curb the current upward BP trend in Chinese children.
authors.affiliation: Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, China Centre for Chronic Disease, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Bin
authors.initials: B
authors.lastname: Dong
authors.affiliation: Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, China Centre for Chronic Disease, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Zhiqiang
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Song
authors.affiliation: Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, China.
authors.forename: Hai-Jun
authors.initials: HJ
authors.lastname: Wang
authors.affiliation: Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Ma
mesh_terms: D000293:Adolescent; D044466:Asian People; D001794:Blood Pressure / Q000502:physiology*; D015992:Body Mass Index; D002648:Child; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D009765:Obesity / Q000453:epidemiology / Q000503:physiopathology; D015995:Prevalence
keywords: blood pressure; children; obesity; trends