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Prevalence and risk factors for hypertension in Hong Kong Chinese adolescents: waist circumference predicts hypertension, exercise decreases risk
  1. Lettie C K Leung1,
  2. Rita Y T Sung2,
  3. Hung-Kwan So2,
  4. Sik Nin Wong3,
  5. Kwok Wai Lee4,
  6. Kwok Piu Lee5,
  7. Man Ching Yam2,
  8. Samantha P S Li3,
  9. So Fun Yuen6,
  10. Stella Chim7,
  11. Keung Kit Chan1,
  12. David Luk8
  1. 1Department of Paediatrics, Kwong Wah Hospital, Kowloon, Hong Kong, China
  2. 2Department of Paediatrics, Prince of Wales Hospital, Shatin, Hong Kong, China
  3. 3Department of Paediatrics, Tuen Mun Hospital, Tuen Mun, Hong Kong, China
  4. 4Department of Paediatrics, Queen Elizabeth Hospital, Kowloon, Hong Kong, China
  5. 5Department of Paediatrics, Alice Ho Miu Ling Nethersole Hospital, Tai Po, Hong Kong, China
  6. 6Department of Paediatrics, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China
  7. 7Department of Paediatrics, Queen Mary Hospital, Hong Kong, China
  8. 8Department of Paediatrics, United Christian Hospital, Kwun Tong, Hong Kong, China
  1. Correspondence to Dr Lettie C K Leung, Department of Paediatrics, Kwong Wah Hospital, 25 Waterloo Road, Kowloon, Hong Kong, China leungckl{at}


Purpose To determine the prevalence, risk factors for and patterns of hypertension in Chinese adolescents based on a territory-wide school based screening programme in Hong Kong.

Methods Cross-sectional anthropometric and oscillometric blood pressure (BP) measurements and lifestyle information were obtained as part of a growth survey of students from randomly selected secondary schools in Hong Kong. Those with blood pressure ≥95th centile were screened a second or third time. Hypertension is defined as elevated blood pressure on three separate occasions. The independent effects of age, sex, body mass index, high waist circumference (≥85th centile), sleep duration, family history of hypertension and frequency of exercise on hypertension were explored by multivariate analysis.

Results Among the 6193 students screened, the prevalence of elevated blood pressure on the first, second and third screens was 9.54%, 2.77% and 1.44% respectively. Hypertension was more likely to be systolic. High waist circumference (≥85th centile) was independently associated with a higher risk of hypertension (adjusted OR 2.4), while exercising twice or more per week was protective (adjusted OR 0.28).

Conclusions The prevalence of hypertension in Hong Kong Chinese adolescents is 1.44%. The current study shows high waist circumference is a predictor of hypertension in adolescents, while increased physical activity is a protective factor. Incorporating waist circumference into screening protocols may increase the sensitivity of cardiovascular risk stratification. Healthcare providers should be strong advocates helping to prevent obesity and promote physical activity in adolescents and children.

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  • Funding This study was supported by the Hong Kong Paediatric Nephrology Society with a research grant from the Children's Kidney Trust Fund.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Hospital Authority Kowloon West Cluster Ethics Committee, Hong Kong.

  • Provenance and peer review Not commissioned; externally peer reviewed.