Prevalence And Influencing Factors Of Hypertension In School Children And Adolescents Aged 6～18 Years In Hainan Province

Objective: To understand the prevalence,distribution characteristics and influencing factors of hypertension in school children and adolescents aged 6～18 in Hainan Province,and to provide theoretical and scientific basis for the prevention and intervention of hypertension in children and adolescents.Methods:The physical fitness monitoring data of school children and adolescents aged 6～18 in Hainan province from 2013 to 2020 were analyzed.A total of 6 253567 pieces of information were included.Kruskal-Wallis H test,Nemenyi test and Mann-Whitney U test were used to analyze whether the blood pressure distribution of children and adolescents at all levels was the same in different ages,years and regions.Spearman rank correlation,chi-square test and multivariate logistic regression were used to analyze the relationship among body mass index,waist circumference,waist-to-height ratio,spirometry index and blood pressure.From November to December 2021,a total of 3,558 grade two students were selected from five middle schools in Haikou city,Lingshui Li Autonomous County and Changjiang Li Autonomous County by cluster random sampling method.Chi-square test and multivariate logistic regression analysis were used to explore the influence of different factors on hypertension in children and adolescents.Physical fitness monitoring data of children and adolescents aged 7～15 years in Haikou city were selected from the total database.A total of 1 469 437 pieces of information were included in the Blood Pressure Reference Standards for Sex,Age,Height of Chinese Children Aged 3～17(referred to as Fan Hui 2017 Standard);A National Blood Pressure Reference For Chinese Han Children and Adolescents Aged 7～17 Years(referred to as Ma Jun 2017 standard);The Cut-off Value of Hypertension in Children Aged 6～15 Years in Haikou City(referred to as Haikou Standard);Study and Formulation of Reference Standards for Blood Pressure in Chinese Children and Adolescents(referred to as Mijie 2010 standard)to determine the blood pressure of children and adolescents at all levels.Kappa test was used to analyze the consistency of decision results of different criteria.Results:1.The characteristics of hypertension in school children and adolescents aged 6～18 years old in Hainan Province are as follows:(1)After 13 years of age,the detection rate of elevated blood pressure in boys increased significantly higher than that of girls,and after 14 years of age the detection rate of stage 1 hypertension in boys increased significantly.The severity of blood pressure in girls aged 6～13 was higher than that of boys of the same age(P<0.001 for each group),and the severity of blood pressure in boys aged 14～17 was higher than that of girls of the same age(P<0.001 for each group).(2)There are regional differences in the distribution of hypertension among children and adolescents(P<0.001),and the severity of blood pressure from high to low is in the southern region,eastern region,western region,central region and northern region.(3)Multivariate logistic regression analysis showed that female students [odds ratio(OR)=1.185,95%CI:1.180～1.189],body mass index overweight and obesity(OR=1.144,95%CI:1.135～1.154;OR=1.120,95%CI:1.105～1.135),high normal waist circumference and high waist circumference(OR=1.053,95%CI:1.046～1.061;OR=1.025,95%CI:1.012～1.037)and abdominal obesity(OR=1.286,95%CI:1.270～1.303)were risk factors for hypertension in children and adolescents in Hainan Province.Age(OR=0.922,95%CI:0.922～0.923),spiro-index middle level,middle and upper level,first-class level(OR=0.956,95%CI:0.944～0.968;OR=0.869,95%CI:0.858～0.880;OR=0.739,95%CI:0.726～0.753)were protective factors for hypertension in children and adolescents in Hainan Province.2.The questionnaire results showed that unoverweight mothers during pregnancy(OR=0.363,95%CI:0.283～0.464),child nap time(<30 minutes:OR=0.305,95%CI:0.203～0.457;30～60 minutes:OR=0.414,95%CI:0.303～0.564;60～120 minutes:OR=0.246,95%CI:0.167～0.363)were protective factors for hypertension in children and adolescents in Hainan Province;Children living with their grandparents(OR=2.716,95%CI:2.027～3.639),eating pickled food 6～7 times per week(OR=3.119,95%CI:2.037～4.775)were risk factors for hypertension in children and adolescents in Hainan Province.3.Hypertension in children and adolescents was assessed according to four different standards,with the highest consistency between Haikou standard and Ma Jun 2017 standard(Kappa value =0.825,P <0.001).Conclusion: In Hainan Province,the detection rate of hypertension among school children and adolescents aged 6 to 18 was 23.79%.Hypertension in children and adolescents is related to various physical fitness monitoring indicators,living habits and eating habits.It is suggested that by combining exercise and reasonable diet,the body mass index,waist circumference and waist-to-height ratio of children and adolescents should be controlled within the normal range and improve the spirometry index.Keep light diet,reduce the intake of pickled food,develop the habit of nap,try to live with parents,and control the mother’s weight to avoid overweight during pregnancy.Fan Hui 2017 standard hypertension detection rate is the highest.Haikou standard is the lowest.