*Judit Kormos-Tasi1, Erika Gácsi1, Fanni Tóth2, Antal Czinner 1, 2, László Szabó1, 2
Cardiovascular screening program in children in Budapest
1Department of Family Care Methodology Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
Head of Faculty: Professor Zoltán Zsolt Nagy, PhD
2Heim Pál Children Hospital, Budapest, Hungary
Head of Hospital: Anikó Nagy, MD
Summary
Introduction. Obesity is one of the most common health problems of the developed countries. The prevalence is increasing among adults and children alike. In Hungary, the prevalence in children is 9-10%. In 1998, WHO (World Health Organization) classified obesity as a disease. Obesity, and other metabolic, endocrine and musculoskeletal diseases that are caused by obesity are seen as one of the biggest public health-related problem nowadays. Obesity increases the morbidity and mortality in all the populations.
Aim. The aim of our screening program was to investigate the prevalence of obesity and its association with hypertension in children.
Material and methods. A screening program was conducted between April 2010 and May 2011. The screening consisted of measuring blood pressure, heart rate, cholesterol, blood glucose, weight, height, calculating BMI, and determination of body composition.
Results. 2226 children aged 14-18 fullfilling the inclusion criteria participated in the program. 13% of the participants were overweight (i.e. their BMI was in between the 85th and 95th percentile of the BMI for their age) and 4% of them were obese (i.e. their BMI was above the 95th percentile for their age). High body fat content was detected in 12.98% of girls and 5.9% of boys that participated in the study. 66% of girls and 81% of boys with elevated BMI had high body fat content. Mean cholesterol level was significantly higher in the group of overweight and obese participants than in the group of participants with normal BMI. Mean systolic and diastolic blood pressure differed significantly between groups with different BMI for both girls and boys, with overweight participants most likely to have pathologically high blood pressure.
Conclusions. There was a significant increase in both systolic and diastolic blood pressure with an increase in BMI. The results of our study may help design preventive programmes for obesity and hypertension in children.

Introduction
Obesity and hypertension are two most important risk factors for cardiovascular diseases (1, 2).
Obesity is one of the most common health problems of the developed countries. The prevalence is increasing among adults and children alike. In Hungary, the prevalence in children is 9-10%. In 1998, WHO (World Health Organization) classified obesity as a disease. Obesity, and other metabolic, endocrine and musculoskeletal diseases that are caused by obesity are seen as one of the biggest public health-related problem nowadays. Obesity increases the morbidity and mortality in all the populations.
Aim
The aim of this screening was to investigate the frequency of obesity and its association with hypertension in a sample of children and adolescents in Budapest. The results of the study will help to design programmes for the prevention and controll of the disease in childhood, which could decrease the potential of chronic disease in adulthood.
Material and methods
A screening program was conducted between April 2010 and May 2011 in Budapest. The screening program was conducted by the City Council and with medical supervision of the professionals from the “Heim Pál” Children Hospital in Budapest.
The screening program was financed by the City Council of Budapest. The screening consisted of measuring blood pressure, heart rate, cholesterol, blood glucose, weight, height, calculating BMI, and determination of body composition.
A sample of 2467 healthy children and adolescents (958 boys and 1509 girls) from the selected schools participated in the study. There were no special inclusion criteria. The participation in the screening program was voluntary and informed consent from the parents, as well as from the adolescents, was obtained in all cases. The study was approved by the Institutional Research Ethical Committee of Heim Pál Children Hospital, Budapest.
Our screening program was a local program conducted in Budapest, in which we examined different areas: full orthopedic screening, eyesight screening, hearing screening, dentistry screening, internal medicine screening, celiac screening, cardiovascular screening and mental hygiene test as described previously in ”New Medicine” in 2014 (3). The included students took part in all types of examinations, but in this study, we only analyze the results of the cardiovascular program. Obesity was defined as having BMI value greater than 95th percentile for participant’s age and sex, and overweight was defined as having BMI value between the 85 and 95th percentile. The body composition was measured through multi-frequency bioelectric impedance analysis (Inbody 3.0 Biospace device). We considered the body fat (BF) to be abnormally high when it was greater than 25% for boys and 30% for girls (4). The serum cholesterol level greater than 5.0 mmol/l and fasting blood glucose greater than 5.5 mmol/l was considered abnormal.
Blood pressure was measured using a standardized automatic blood pressure meter. To diagnose hypertension in pediatric population, systolic and/or diastolic pressure value greater than 95th percentile for age, sex and height is required (5). If a student had mean blood pressure greater than the 95th percentile for age and height, their blood pressure was remeasured at Heim Pál Children Hospital due to safety considerations.
Microsoft Office Excel was used to process the collected data. For continuous variables, including age, weight, height, BMI, and blood pressure, mean and range were calculated. Categorical variables were summarized by count and percentage. The data was analysed using the SPSS Statistica 20.0 software. Level of statistical significance alpha was defined as p < 0.05.
Results
Powyżej zamieściliśmy fragment artykułu, do którego możesz uzyskać pełny dostęp.
Mam kod dostępu
- Aby uzyskać płatny dostęp do pełnej treści powyższego artykułu albo wszystkich artykułów (w zależności od wybranej opcji), należy wprowadzić kod.
- Wprowadzając kod, akceptują Państwo treść Regulaminu oraz potwierdzają zapoznanie się z nim.
- Aby kupić kod proszę skorzystać z jednej z poniższych opcji.
Opcja #1
19 zł
Wybieram
- dostęp do tego artykułu
- dostęp na 7 dni
uzyskany kod musi być wprowadzony na stronie artykułu, do którego został wykupiony
Opcja #2
49 zł
Wybieram
- dostęp do tego i pozostałych ponad 7000 artykułów
- dostęp na 30 dni
- najpopularniejsza opcja
Opcja #3
119 zł
Wybieram
- dostęp do tego i pozostałych ponad 7000 artykułów
- dostęp na 90 dni
- oszczędzasz 28 zł
Piśmiennictwo
1. Landsberg L, Aronne LJ, Beilin LJ et al.: Obesity-related hypertension: pathogenesis, cardiovascular risk, and treatment: a position paper of The Obesity Society and the American Society of Hypertension. Obesity 2013; 21: 8-24. DOI: 10.1002/oby.20181. 2. Ogden CL, Carroll MD, Kit BK, Flegal KM: Prevalence of obesity and trends in body mass index among US children and adolescents, 1999-2010. JAMA 2012; 307: 483-490. 3. Kormos-Tasi J, Szabó L, Bossányi É et al.: Results of the child obesity – “Tabula rasa” screening program. New Med 2014; 2: 72-74. 4. Czinner A: A szív-èsèrrendszeri megbetegedèsek gyermekkori prevenciója. Medicina Könyvkiadó Rt. Budapest 2003: 27. 5. Falkner B, Daniels SR: Summary of the fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Hypertension 2004; 44: 387-388. 6. Basiratnia M, Derakhshan D, Ajdari S, Saki F: Prevalence of childhood obesity and hypertension in south of Iran. Iran J Kidney Dis 2013; 7: 282-289. 7. Valdès Pizarro J, Royo-Bordonada MA: Prevalence of childhood obesity in Spain: National Health Survey 2006-2007. Nutr Hosp 2012; 27: 154-160. 8. Kollias A, Skliros E, Stergiou GS et al.: Obesity and associated cardiovascular risk factors among schoolchildren in Greece: a cross-sectional study and review of the literature. J Pediatr Endocrinol Metab 2011; 24: 929-938. 9. Raison J, Achimastos A, Asmar R et al.: Extracellular and interstitial fluid volume in obesity with and without associated systemic hypertension. Am J Cardiol 1986; 57: 223-226. 10. Flynn JT, Falkner BE: Obesity hypertension in adolescents: epidemiology, evaluation, and management. J Clin Hypertens (Greenwich) 2011; 13: 323-331. 11. Pall D, Katona E, Fulesdi B et al.: Blood pressure distribution in a Hungarian adolescent population: comparison with normal values in the USA. J Hypertens 2003; 21: 41-47. 12. Muntner P, He J, Cutler JA et al.: Trends in blood pressure among children and adolescents. JAMA 2004; 291(17): 2107-2113. 13. Steinthorsdottir SD, Eliasdottir SB, Indridason OS et al.: Prevalence of hypertension in 9- to 10-year-old Icelandic school children. J Clin Hypertens (Greenwich) 2011; 13: 774-779. 14. Sharma A, Grover N, Kaushik S et al.: Prevalence of hypertension among school children in Shimla. Indian Pediatr 2010; 47: 873-876. 15. Ibrahim MM, Damasceno A: Hypertension in developing countries. Lancet 2012; 380: 611-619.