title: Environmental variation in the prevalence of hypertension in children and adolescents - is blood pressure higher in children and adolescents living in rural areas?
abstract: BACKGROUND
  Despite considerable progress in diagnostic methods and treatment options, cardiovascular diseases constitute a serious health issue in Poland, and hypertension is considered one of the main risk factors in the incidence of the diseases.
  
  
  OBJECTIVE
  The aim of this study is to assess the values of arterial blood pressure among adolescents in the context of urban and rural environments.
  
  
  METHODS
  The study was carried out on a representative, randomly selected group of youths aged 10-18 years, participating in the ADOPOLNOR project. Prior to blood pressure measurement, each pupil was assessed according to anthropomorphic principles. The BP measurements strictly followed the guidelines of the Fourth Protocol of the American Working Group of High Blood pressure in Children and Adolescents.
  
  
  RESULTS
  Mean values of systolic blood pressure (SBP) in boys in rural areas were higher in every age group than in the boys in urban areas. Higher values of systolic and diastolic blood pressure were observed also in girls in rural areas. BP values sufficiently high for the diagnosis of hypertension were observed in 12.8% of the rural boy population but only in 6.7% of the boys from the urban environment. The difference is statistically significant. The girls in rural areas (13.3%) had twice the incidence of elevated BP values in comparison with the girls in urban areas (7.2%) and, as in boys, the difference is statistically significant.
  
  
  CONCLUSIONS
  The high proportion of pupils with elevated arterial blood pressure observed in the rural areas of Wielkopolska calls for regularly performed BP assessment and monitoring in this populatio.
authors.affiliation: Department of Epidemiology Chair of Social Medicine, Poznan University of Medical Sciences, Poland.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Krzywinska-Wiewiorowska
authors.affiliation: Department of Epidemiology Chair of Social Medicine, Poznan University of Medical Sciences, Poland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Stawińska-Witoszyńska
authors.affiliation: Department of Epidemiology Chair of Social Medicine, Poznan University of Medical Sciences, Poland.
authors.forename: Alicja
authors.initials: A
authors.lastname: Krzyżaniak
authors.affiliation: Institute of Anthropology, Faculty of Biology, Adam Mickiewicz University, Poznan, Poland.
authors.forename: Maria
authors.initials: M
authors.lastname: Kaczmarek
authors.affiliation: Department of Pediatric Cardiology and Nephrology, Poznan University of Medical Sciences, Poland.
authors.forename: Aldona
authors.initials: A
authors.lastname: Siwinska
mesh_terms: D000293:Adolescent; D001794:Blood Pressure; D002648:Child; D003430:Cross-Sectional Studies; D004777:Environment; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D011044:Poland / Q000453:epidemiology; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data; D014505:Urban Population / Q000706:statistics & numerical data