{
  "abstract": "Background Hypertension is one of the leading causes of cardiovascular disease among adults. Hypertension (HT) and elevated blood pressure (EBP) among children can cause cardiac and vascular changes, diastolic and systolic dysfunction. Child and adolescent HT often tracks into adulthood, predicting premature hypertension and cardiovascular disease in adulthood. Understanding prevalence, trends, and risk factors for childhood and adolescent EBP and HT in England can help identify at risk populations, and targets for public health interventions.Methods The Health Survey for England is a repeated cross-sectional health examination survey of adults and children, representative of the general population. This paper uses data from 2003–2019, with 10,495 children aged 5–15. Blood pressure was measured on one occasion, in the home, using an Omron HEM207 sphygmomanometer. Age, sex and height-specific blood pressure thresholds were applied using the Americal Association of Pediatrics 2017 guidelines, with EBP and HT defined as the 90th and 95th centiles respectively. BMI was calculated from measured height and weight, and deprivation defined by IMD quintile. Analysis was completed using STATA 18, using complex survey design and survey weights.Results The prevalence of EBP was 14.2% (95% CI 13.5–15.0%) among children aged 5–15, while 1.8% (1.6–2.1%) had HT.In mutually adjusted results, the odds of EBP were lower for girls than boys (O.R. 0.83, 0.73–0.94), and decreased with age (0.87, 0.85–0.89), and over time (0.97, 0.96–0.99 per survey year). Children who were overweight (1.63, 1.35–1.95) or obese (2.27, 1.95–2.64) had higher odds of EBP pressure than normal weight children. The odds of EBP increased with deprivation, children in the most deprived quintile had 1.65 (1.32–2.00) the odds of those in the least deprived quintile. Ethnicity and region were not statistically significant predictors.HT also decreased with age (OR 0.88, 0.84–0.92), and over time (0.96, 0.93–0.99). Children who were overweight (2.29, 1.48–3.54) or obese (3.22, 2.21–4.69) had higher odds of HT than normal weight children. Sex, ethnicity, deprivation and region were not statistically significant predictors.Discussion While childhood HT should be diagnosed by blood pressure measurements over several occasions, neverless this study adds valuable indicators of the single occasion EBP and HT. Despite high levels of childhood overweight and obesity, and in contrast to international estimates showing increasing childhood hypertension, our study shows that in England prevalence of EBP and HT appear to be gradually decreasing. Nonetheless, childhood EBP and HT continue to be a cause for concern, and efforts should be focussed on improving both prevention and diagnosis.",
  "authors": [
    {
      "affiliations": [
        "Institute of Epidemiology and Public Health, UCL, London, UK"
      ],
      "name": "Alison Moody"
    },
    {
      "affiliations": [
        "Institute of Epidemiology and Public Health, UCL, London, UK"
      ],
      "name": "Linda Ng Fat"
    },
    {
      "affiliations": [
        "Institute of Epidemiology and Public Health, UCL, London, UK"
      ],
      "name": "Jenny Mindell"
    },
    {
      "affiliations": [
        "Centre for Public Health and Policy, Queen Mary University of London, London, UK"
      ],
      "name": "Oyinlola Oyebode"
    },
    {
      "affiliations": [
        "Institute of Epidemiology and Public Health, UCL, London, UK"
      ],
      "name": "Logan Manikam"
    }
  ],
  "title": "OP19 Childhood and adolescent elevated blood pressure and hypertension 2003–2019: analysis of trends and risk factors using the health survey for England",
  "uid": "f1f6f310-37b1-5373-bb0b-792ec3febcc8"
}