Hypertension In Children And Adolescents And Its Association With Body Weight: A Meta-analysis

ObjectiveThrough the meta-analysis method,systematically review the findings of all the past 16 years'studies and estimate the overallprevalenceofhypertensionofChinesechildrenand adolescents.To analyze the relationship between abnormal birth weight and hypertension in children and adolescents,and to explore the role of BMI.Providing the basis to the early intervention of hypertension-related risk factors,blocking the cause of the chain andreduce the prevalence of hypertension in children and adolescents.This is the help of hypertension prevention and control work.Method?1?Comprehensive electronic searches of Chinese Web of Knowledge?CNKI?,Wang Fang,Wei Pu?VIP?,PubMed and Web of Science were conducted to identify any study in each database published from January 1,2000 to December 31,2015,reporting the prevalence of hypertension of Chinese children and adolescents.The R 3.2.2 software was used to test the original rate and the conversion rate of the samples,and the rate values corresponding to the normal distribution were selected.?2?Major electronic databases including PubMed,Web of Science,China National Knowledge Infrastructure?CNKI?,Wanfang database and Weipu database were searched until December 2016.Epidemiological studies addressing the association between birth weight and blood pressure of child and adolescent were enrolled.The heterogeneity across studies was explored by chi-squared test and I² statistic.The possibility of publication bias was assessed using Egger's tests.The results were reported based on standardised mean difference?SMD?and odds ratio?OR?with 95%confidence intervals?CI?.Result?1?48 studies were included in this study,the total number of population was 396?785.Random effects model was used for data consolidation,prevalence of Chinese children and adolescents is 6.47%?95%CI=5.41%⁷.73%?;Prevalence of hypertension in males were higher than females regardless age?puberty 6.75%vs 5.87%,before puberty 9.25%vs 7.61%?.After puberty,the female growth of prevalence rate is slower than men;Prevalence of hypertension in the north?7.91%?is more serious than the south?5.31%?;The prevalence of hypertension in the eastern is the highest;Prevalence of hypertension for urban?8.70%?is more serious than the rural?7.60%?;The overall prevalence rate decreased?8.06%vs 5.10%?,but rebounded in the past five years?6.89%?.?2?We identified a total of 4988 references and included 34studies.Compared to children and adolescents birth weight greater than2500g,lowbirthweightsubjectshaveahigherriskof hypertension?OR=1.20;95%CI 1.09,1.33;P<0.0001?.Their systolic and diastolic blood pressure are also high.There was no statistically significant difference in risk of hypertension between children and adolescents with birth weight greater than 4000 g and less than 4000g?OR=1.03;95%CI 0.89,1.18;P>0.05?.But high birth weight subjects'systolic and diastolic blood pressure are high.?3?A total of 59 studies ontherelationshipbetweenobesityandhypertensionwere included.Compared with the normal group,High BMI groups are at higher risk of developing hypertension?OR=3.919;95%CI 3.352,4.583?.The risk of hypertension in overweight adolescents was 2.6 times higher than the normal group?OR=2.556;95%CI 2.264,2.885?.The risk of hypertension in obesity adolescents was 5.6 times higher than the normal group?OR=5.620;95%CI 4.739,6.664?.?4?A total of 33 studies on the correlation between birth weight and overweight among children and adolescents were included.The risk of overweight and obesity in the low birth weight exposure group was 0.65 times higher than in the unexposed group?OR=0.65;95%CI 0.59,0.71?.The risk of overweight and obesity in the high birth weight exposure group was 1.81 times higher than in the unexposed group?OR=1.81;95%CI 1.62,2.03?.Conclusion?1?The prevalence of hypertension in Chinese children and adolescents is lower than that of adults,but still at a high level that can not be ignored.So we have to strengthen health education,to develop a reasonable diet,sports programs and other aspects of intervention.?2?Low birth weight and high birth weight have a certain effect on childhood and adolescent blood pressure values.Low birth weight is more obvious,and may even lead to children and adolescents suffering from high blood pressure.The impact of high birth weight is much less than the low birth weight,did not reach the level of disease caused by hypertension.?3?Overweight is a risk factor for the prevalence of hypertension among children and adolescents.?4?High birth weight is a risk factor for overweight and obesity among children and adolescents.Low birth weight is a protective factor for overweight and obesity among children and adolescents.?5?Birth weight had an effect on childhood adolescents with lower blood pressure through BMI.But it has less impact.Birth weight as an early evaluation of intrauterine nutrition and development indicators,abnormal birth weight reflects the structural and functional changes of fetal adaptive regulation.causing poor renal function or small blood vessels abnormalities.Poor renal function or small vessel abnormalities increase the risk of developing hypertension.