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Characterization of the Blood Presure Values in Children from 5 to 14 years old living in Guantanamo, Cuba
Elías Sierra, Reinaldo; Betancourt Pulsan, Anselma; Armas López, Marisel; Pérez de la Iglesia, Sulay
General Teaching Hospital " Dr. Agostinho Neto"Abstract
Introduction
Objectives
Methods
Results
Discussion
Conclusions
Abstract
Introduction: prevalence of systemic blood hypertension (BP) differs
according to the regions of the world. Criteria for diagnosis in children have not been
internationally established, a fact that restricts measuring the problem. The importance
of this study is revealed, since in Cuba figures extrapolated from other countries are
used, although influence by geographic factors has been confirmed, so that each country is
required to establish its patterns in their own population, due to the problem of
comparing people genetically different.
Objectives: Establish patterns of systemic blood pressure (percentiles 90
and 95) according to age and sex, and reflects the influence in these by family history in
first degree of blood hypertension (FHFD-BP).
Method: We studied 200 children from Guantanamo (100 male and 100 female)
in each year of age, from 5 to 14 (n=2000), selected at random according to age, sex,
nutritional state. Systolic and diastolic systemic blood hypertension is registered by the
Korotkoff method, and international recommendations. Results are validated by the analysis
of variance, and the student test.
Results: In males and children with FHFD-BP the figures of systemic blood
pressure are higher (p<0.01) regardless of age, sex, and nutritional state. Percentiles
90 and 95 are established for systolic and diastolic systemic blood pressure for this
population.
The Systematic Arterial Hypertension is one of the main cardiovascular risk factors and
it represents a health problem in our contemporary world. To modify its epidemiologic
behavior in Cuba is a priority of the Ministry of Public Health.
Hypertension affects children; however, no internationally conclusive criteria have been
established for its diagnosis in infants, Cuba has been using those criteria brought from
others countries, despite the fact that it has been proveen that they are modified by the
influence of geographic factors which demand that each country makes an effort to
establish its own patterns due to the inconvenience of comparing genetically different
populations whose life-style are developed in different environmental conditions .
To specify the values of systematic blood pressure in a sample of Cuban children from 5 to 14 years old living in Guantanamo Municipality in 1998, their patterns and the percentiles 90 and 95 according to age and sex, and to notice the influence of first degree family antecedent in them.
A descriptive and applied study was carried out in Guantanamo
Municipality, Cuba in 1998. Three hundred children were studied per each age group from 5
to 14 years old (150 girls and 150 boys in each year) for a total of 3000 unit of
analysis. They were selected at random matched by age, sex and skin color.
They had to fullfill the following criteria: have Cuban parents, be authorized by their
parents to undergo the research, not to have suffered from any desease or taken any kind
of medications or chemical substances that affect the BP values for at least 5 lives
average. Eutrophic nutritional state.
The BP valves were registered according to the international standars (norms) and
following Korotkoff ausculatory method. After the evaluation of every 100 units of
analysis was completed the monitoring quality was controlled. Each child was measured
twice by the same evaluator with intervals of 30 minutes.
To satisfy the objectives of the research in each subject the age, sex, first degree
family antecedent of BP ( mother, father, brothers and sisters), so as the systolic
pressure and diastolic pressure were defined. The average values and the standard
deviations were established so as the percentile 90 and 95 for systolic and diastolic
pressures for each subgroup according to age and sex. The differences between groups were
validated according to the analysis of variance or the test for the different averages for
a level of significancy of p£ 0.05.
The tables reflect the average values standard deviations and percentiles 90 and 95 for systolic pressure and diastolic pressure for each subgroup of age and sex, so as the influence of the family antecedent of BP in the values of systolic pressure and diastolic pressure.
Table 1
Characterization of the values of blood pressure ( mm Hg) according to age and sex
Legend: X: Average SD: Standart Deviation
Legend: F: Female M: Male P: Percentiles
Legend: X: Average SD: Standart Deviation
The Panamerican Health Organization has proclaimed the need to
establish the BP values in children and adolescents for their application in Latin America
and the Caribbean taking into account the regional differences. In the research, the
increase of BP according to the age and its higher values for boys and children with
family antecedent of systematic Arterial Hypertension were proven.
These resukts were similar to those of others authors who affirm the BP increase according
to weight and height or index of corporial mass.
In general the systolic and diastolic values (percentiles 90 and 95) established in the
research are inferior to those nominated by the "Task Force on Blood Pressure Control
in Children" may be due to regional differences . The BP higher values in boys could
be related to a higher neurovegetative vulnerability and vascular reactivity in them. The
family antecedent of hypertension has been checked in hypertensive children in all age
groups and it is stated that the first degree descendants of hypertensive patiens are in
more risk of suffering from hypertension in the future.
The systolic and diastolic pressures so as the respective percentiles 90 and 95 for a Cuban infant population in Guantanamo (5 to 14 years old) are established, reflecting significant differences in such respect according to sex (higher in boys) and family antecedent of hypertension.
Questions, contributions and commentaries to the Authors: send an e-mail message (up to 15 lines, without attachments) to hbp-pcvc@pcvc.sminter.com.ar , written either in English, Spanish, or Portuguese.
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