Abstract
As the first blood pressure (BP) reference considering influence of height in China, national blood pressure reference for Chinese han children and adolescents aged 7 to 17 years (CCBP) was issued in 2017. The current study aimed to observe the short-term trends in BP and prevalence of high blood pressure (HBP) and high normal blood pressure (HNBP) using this CCBP reference in Suzhou, China. Data of children and adolescents aged 7 to 17 years were collected from 2014 to 2017. Total population of 2014 to 2017 were 617,383, 684,453, 695,302, and 774,605, respectively, and proportions of males were 54.1%, 54.0%, 53.9%, and 53.8%, respectively. P-trend tests were conducted to examine the trends of BP among different age, region, body mass index, and socioeconomic status groups for each gender. Multivariate logistic regression analyses found secular decreases in prevalence of HBP and HNBP, after adjustment for potential confounders. Compared with that in 2014, the odds ratios (95% confidence intervals) for total study population were 0.936 (0.928, 0.944) in 2015, 0.879 (0.872, 0.887) in 2016, and 0.934 (0.926, 0.941) in 2017. In conclusion, prevalence of HBP and HNBP decreased among children and adolescents in developed regions of China from 2014 to 2017, and a slight rise were found in 2017.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 digital issues and online access to articles
$119.00 per year
only $9.92 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Ezzati M, Hoorn SV, Lopez AD, Danaei G, Rodgers A, Mathers CD, et al. Comparative quantification of mortality and burden of disease attributable to selected risk factors. In: Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJL, editors. Global burden of disease and risk factors. Washington, DC: World Bank; 2006. Chapter 4.
Chiolero A, Bovet P, Paradis G. Screening for elevated blood pressure in children and adolescents: a critical appraisal. JAMA Pediatr. 2013;167:266–73.
Roulet C, Bovet P, Brauchli T, Simeoni U, Xi B, Santschi V, et al. Secular trends in blood pressure in children: a systematic review. J Clin Hypertens. 2017;19:488–97.
Ingelfinger JR. The child or adolescent with elevated blood pressure. N Engl J Med. 2014;371:1075.
Flynn JT, Kaelber DC, Baker-Smith CM, Blowey D, Carroll AE, Daniels SR, et al. Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics. 2017;140:e20171904.
Chen X, Wang Y. Tracking of blood pressure from childhood to adulthood: a systematic review and meta-regression analysis. Circulation. 2008;117:3171–80.
Dong Y, Ma J, Song Y, Dong B, Wang Z, Yang Z, et al. National blood pressure reference for chinese han children and adolescents aged 7 to 17 years. Hypertension. 2017;70:897–906.
Dong YH, Song Y, Dong B, Zou ZY, Wang ZH, Yang ZG, et al. Association between the blood pressure status and nutritional status among Chinese students aged 7-18 years in 2014: based on the national blood pressure reference for Chinese children and adolescents. Beijing Da Xue Xue Bao Yi Xue Ban. 2018;50:422–8.
Dong Y, Ma J, Song Y, Ma Y, Dong B, Zou Z, et al. Secular trends in blood pressure and overweight and obesity in Chinese boys and girls aged 7 to 17 years from 1995 to 2014. Hypertension. 2018;72:298–305.
Hao X. Science in China: 30 years on. Cell. 2008;134:375–7.
Hu J, Chu GP, Huang FF, Zhou YK, Teng CG, Yang HB, et al. Relation of body mass index (BMI) to the prevalence of hypertension in children: a 3years’ school-based prospective study in Suzhou, China. Int J Cardiol. 2016;222:270–4.
Group of China Obesity Task F. Body mass index reference norm for screening overweight and obesity in Chinese children and adolescents. Zhong Hua Liu Xing Bing Xue Za Zhi. 2004;25:97–102.
Mi J, Wang TY, Meng LH, Zhu GJ, Han S, Zhong Y, et al. Development of blood pressure reference standards for Chinese children and adolescents. Zhong Guo Xun Zheng Er Ke Za Zhi. 2010;1:4–14.
Chiolero A, Bovet P, Paradis G, Paccaud F. Has blood pressure increased in children in response to the obesity epidemic? Pediatrics. 2007;119:544–53.
Xi B, Zhang T, Zhang M, Liu F, Zong X, Zhao M, et al. Trends in elevated blood pressure among US children and adolescents: 1999-2012. Am J Hypertens. 2016;29:217–25.
Khang YH, Lynch JW. Exploring determinants of secular decreases in childhood blood pressure and hypertension. Circulation. 2011;124:397–405.
Shirasawa T, Ochiai H, Nishimura R, Morimoto A, Shimada N, Ohtsu T, et al. Secular trends in blood pressure among Japanese schoolchildren: a population-based annual survey from 1994 to 2010. J Epidemiol. 2012;22:448–53.
Kouda K, Nakamura H, Nishio N, Fujita Y, Takeuchi H, Iki M. Trends in body mass index, blood pressure, and serum lipids in Japanese children: Iwata population-based annual screening (1993-2008). J Epidemiol. 2010;20:212–8.
Agirbasli M, Tanrikulu B, Arikan S, Izci E, Ozguven S, Besimoglu B, et al. Trends in body mass index, blood pressure and parental smoking habits in middle socio-economic level Turkish adolescents. J Hum Hypertens. 2008;22:12–17.
Freedman DS, Goodman A, Contreras OA, DasMahapatra P, Srinivasan SR, Berenson GS. Secular trends in BMI and blood pressure among children and adolescents: the Bogalusa Heart Study. Pediatrics. 2012;130:e159–166.
Liang YJ, Xi B, Hu YH, Wang C, Liu JT, Yan YK, et al. Trends in blood pressure and hypertension among Chinese children and adolescents: China Health and Nutrition Surveys 1991-2004. Blood Press. 2011;20:45–53.
Xi B, Liang Y, Mi J. Hypertension trends in Chinese children in the national surveys, 1993 to 2009. Int J Cardiol. 2013;165:577–9.
Kollias A, Antonodimitrakis P, Grammatikos E, Chatziantonakis N, Grammatikos EE, Stergiou GS. Trends in high blood pressure prevalence in Greek adolescents. J Hum Hypertens. 2009;23:385–90.
McCrindle BW, Manlhiot C, Millar K, Gibson D, Stearne K, Kilty H, et al. Population trends toward increasing cardiovascular risk factors in Canadian adolescents. J Pediatr. 2010;157:837–43.
Danaei G, Finucane MM, Lin JK, Singh GM, Paciorek CJ, Cowan MJ, et al. National, regional, and global trends in systolic blood pressure since 1980: systematic analysis of health examination surveys and epidemiological studies with 786 country-years and 5.4 million participants. Lancet. 2011;377:568–77.
Dong B, Wang Z, Song Y, Wang HJ, Ma J. Understanding trends in blood pressure and their associations with body mass index in Chinese children, from 1985 to 2010: a cross-sectional observational study. BMJ Open. 2015;5:e009050.
Zhang Y-X, Zhao J-S, Sun G-Z, Lin M, Chu Z-H. Prevalent trends in relatively high blood pressure among children and adolescents in Shandong, China. Ann Hum Biol. 2012;39:259–63.
Tao RW, Wan YH, Zhang H, Wang YF, Wang B, Xu L, et al. Relationship between hypertension and percentage of body fat, in children of Anhui province. Zhong Hua Liu Xing Bing Xue Za Zhi. 2016;37:178–82.
Niu X, Zhao HP, Zhang YH. Comparison of blood pressure among children aged 7-17 of Hui minority in Ningxia from 2005-2014. Zhong Guo Xue Xiao Wei Sheng. 2017;12:1869–72.
Hu L, Huang X, You C, Li J, Hong K, Li P, et al. Prevalence and risk factors of prehypertension and hypertension in Southern China. PLoS ONE. 2017;12:e0170238.
Lu Y, Luo B, Xie J, Zhang X, Zhu H. Prevalence of hypertension and prehypertension and its association with anthropometrics among children: a cross-sectional survey in Tianjin, China. J Hum Hypertens. 2018. https://doi.org/10.1038/s41371-018-0088-4.
Yang G, Ma Y, Wang S, Su Y, Rao W, Fu Y, et al. Prevalence and correlates of prehypertension and hypertension among adults in Northeastern China: a cross-sectional study. Int J Environ Res Public Health. 2015;13:82.
Zhang YX, Zhou JY, Zhao JS, Chu ZH. Urban-rural and regional disparities in the prevalence of elevated blood pressure among children and adolescents in Shandong, China. Int J Cardiol. 2014;176:1053–5.
Dong B, Wang Z, Ma J. Urban-rural disparity in blood pressure among Chinese children: 1985-2010. Eur J Public Health. 2016;26:569–75.
Wang CP, Ma SJ, Xu XF, Wang JF, Mei CZ, Yang GH. The prevalence of household second-hand smoke exposure and its correlated factors in six counties of China. Tob Control. 2009;18:121–6.
Yang BY, Qian Z, Howard SW, Vaughn MG, Fan SJ, Liu KK, et al. Global association between ambient air pollution and blood pressure: a systematic review and meta-analysis. Environ Pollut. 2018;235:576–88.
Din-Dzietham R, Liu Y, Bielo MV, Shamsa F. High blood pressure trends in children and adolescents in national surveys, 1963 to 2002. Circulation. 2007;116:1488–96.
Yan W, Li X, Zhang Y, Niu D, Mu K, Ye Y, et al. Reevaluate secular trends of body size measurements and prevalence of hypertension among Chinese children and adolescents in past two decades. J Hypertens. 2016;34:2337–43.
Chiolero A, Paradis G, Madeleine G, Hanley JA, Paccaud F, Bovet P. Discordant secular trends in elevated blood pressure and obesity in children and adolescents in a rapidly developing country. Circulation. 2009;119:558–65.
Ewald DR, Haldeman Ph DL. Risk factors in adolescent hypertension. Glob Pediatr Health. 2016;3:1–26.
Yang S, Khang YH, Harper S, Davey Smith G, Leon DA, Lynch J. Understanding the rapid increase in life expectancy in South Korea. Am J Public Health. 2010;100:896–903.
Chen H, Hao L, Yang C, Yan B, Sun Q, Sun L, et al. Understanding the rapid increase in life expectancy in shanghai, China: a population-based retrospective analysis. BMC Public Health. 2018;18:256.
Global Burden of Disease Pediatrics C, Kyu HH, Pinho C, Wagner JA, Brown JC, Bertozzi-Villa A, et al. Global and national burden of diseases and injuries among children and adolescents between 1990 and 2013: findings from the global burden of disease 2013 study. JAMA Pediatr. 2016;170:267–87.
Zhao L, Fang Y, He Y, Yu D, Guo Q, Yu W, et al. Trends of food consumption among Chinese population in 1992-2012. Wei Sheng Yan Jiu. 2016;45:522–6.
Xu Y, Zhang W, Yang R, Zou C, Zhao Z. Infant mortality and life expectancy in China. Med Sci Monit. 2014;20:379–85.
Wang S, Luo K. Life expectancy impacts due to heating energy utilization in China: distribution, relations, and policy implications. Sci Total Environ. 2018;610-611:1047–56.
Wang X, Guo H, Wang L, Li X, Huang M, Liu Z, et al. Investigation of residents’ health literacy status and its risk factors in Jiangsu Province of China. Asia Pac J Public Health. 2015;27:NP2764–72.
Huang C, Zhao X, Lu Y, Wang L, Hu Y, Zhang J, et al. Changes in life expectancy from 2006 to 2015 in Suzhou, East China: contributions of age- and cause-specific mortality. Asia Pac J Public Health. 2018;30:75–84.
He L, Zhai Y, Engelgau M, Li W, Qian H, Si X, et al. Association of children’s eating behaviors with parental education, and teachers’ health awareness, attitudes and behaviors: a national school-based survey in China. Eur J Public Health. 2014;24:880–7.
Jung MH, Ihm SH, Lee DH, Choi Y, Chung WB, Jung HO, et al. Prehypertension is a comorbid state with autonomic and metabolic dysfunction. J Clin Hypertens (Greenwich). 2018;20:273–9.
H Hou, X Feng, Y Li, Z Meng, D Guo, F Wang, et al. Suboptimal health status and psychological symptoms among Chinese college students: a perspective of predictive, preventive and personalised health. EPMA J. 2018;9:367–77.
Wang Y, Klarić L, Yu X, Thaqi K, Dong J, Novokmet M, et al. The association between glycosylation of immunoglobulin g and hypertension: a multiple ethnic cross-sectional study. Medicine (Baltimore). 2016;95:e3379.
Liu JN, Dolikun M, Štambuk J, Trbojević-Akmačić I, Zhang J, Wang H, et al. The association between subclass-specific IgG Fc N-glycosylation profiles and hypertension in the Uygur, Kazak, Kirgiz, and Tajik populations. J Hum Hypertens. 2018;32:555–63.
Lyratzopoulos G1, Heller RF, Hanily M, Lewis PS. Risk factor measurement quality in primary care routine data was variable but nondifferential between individuals. J Clin Epidemiol. 2008;61:261–7.
Acknowledgements
We gratefully acknowledge all participating children and their parents for their collaboration.
Funding
This study was supported by the Youth Program of Reinvigorating the Health through Science and Education in Suzhou, China (kjxw2015035).
Author information
Authors and Affiliations
Corresponding authors
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Additional information
Publisher’s note: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Hu, J., Shen, H., Wu, Jz. et al. Prevalence of high blood pressure and high normal blood pressure among 7- to 17-year-old children and adolescents in developed regions, China from 2014 to 2017: using new national blood pressure reference for Chinese children and adolescents. J Hum Hypertens 33, 400–410 (2019). https://doi.org/10.1038/s41371-019-0183-1
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/s41371-019-0183-1
This article is cited by
-
Association between body composition and blood pressure in normal-weight Chinese children and adolescents
BMC Pediatrics (2022)
-
School-based surveillance on visit-to-visit blood pressure variability and high blood pressure in children and adolescents
BMC Cardiovascular Disorders (2021)
-
The intake assessment of diverse dietary patterns on childhood hypertension: alleviating the blood pressure and lipidemic factors with low-sodium seafood rich in omega-3 fatty acids
Lipids in Health and Disease (2020)
-
Does underweight amplify the relationship between short-term particulate matter exposure and blood pressure in children and adolescents: a large cross-sectional study in a metropolis of China
Environmental Science and Pollution Research (2020)