Secular trends of blood pressure and body size in a multi-ethnic adolescent population: 1986 to 1996,☆☆,

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Abstract

Objectives: To determine the levels and time trends of blood pressure and body size in a healthy population of youth. Study design: Minneapolis, Minnesota, fifth through eighth grade public school children (aged 10 to 14 years) were surveyed in 1986 and 1996. Blood pressure, height, and weight were measured by technicians trained to the same rigorous protocol at each time period, and comparisons were made between the 2 groups (1986 and 1996). Results: In 1986 and 1996, 8222 and 10,241 children, respectively, were measured with participation rates of over 93%. African American, Hispanic, Native American, Asian, and non-Hispanic white groups were all represented. Systolic blood pressure was significantly higher and diastolic blood pressure lower in 1996 than in 1986 in all ethnic and gender groups. Weight and body mass index (wt/ht2) were significantly higher in all groups in 1996. Adjustment for body size largely eliminated the systolic blood pressure differences but had no effect on measured diastolic blood pressure. Conclusions: Body size and systolic blood pressure are rising among school children. Weight and body mass index show substantial increases over 10 years (1986-1996). Diastolic blood pressure fell for unclear reasons. These changes may have future health implications for cardiovascular disease, as these youth move into adulthood. (J Pediatr 1999;134:668-74)

Section snippets

METHODS

This study was approved by the Committee on the Use of Human Subjects in Research of the University of Minnesota. Consent for participation was obtained from Minneapolis Public School children and their parents by means of passive consent. A consent letter was mailed to all parents or guardians of children enrolled in grades 5 to 8, informing them of the upcoming screening, and the post office was asked to return undeliverable letters. Thus every parent received a letter and had the opportunity

RESULTS

The 2 student populations, described in Table I, included 4239 boys and 3983 girls in 1986 and 5223 boys and 5018 girls in 1996.Age (mean ± SD) was 12.1 ± 1.3 years in 1986 compared with 11.9 ± 1.3 years in 1996. There was a shift in the ethnic composition between 1986 and 1996 with declines in non-Hispanic white students and increases in African American, Native American, Hispanic, and Southeast Asian students (Table I), consistent with changes in the Minneapolis population. The substantial

DISCUSSION

Hypertension is common among adults in the United States, affecting 24% of the population aged 18 to 74 in the most recent Third National Health and Nutrition Examination Survey.8 It involves all ethnic groups, but rates are particularly high among African American subjects.2 Despite improvement in BP levels and the treatment of hypertension among adults, the sequelae of stroke, myocardial infarction, renal failure, and heart failure remain among the greatest threats to the public health.

It is

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Supported by the National Institutes of Health, Bethesda, MD (RO1HL52851-02).

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Reprint requests: Russell V. Luepker, MD, Division of Epidemiology, School of Public Health, University of Minnesota, 1300 South Second St, Suite 300, Minneapolis, MN 55454-1015.

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