Blood pressure among Australian Aboriginal children

Nicholas Larkins, Armando Teixeira-Pinto, Emily Banks, Hasantha Gunasekera, Alan Cass, Jane Kearnes, Jonathan C. Craig, on behalf of the SEARCH investigators

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Objectives: To determine the prevalence of elevated blood pressure (BP) and potential predictors of SBP and DBP in urban Australian aboriginal children. 

    Methods: The Study of Environment on Aboriginal Resilience and Child Health is a prospective cohort study of urban Aboriginal children attending four Aboriginal Community Controlled Health Services in New South Wales, Australia. Clinical measures included a manual BP measured by research officers using standardized protocols. BP z-scores adjusted for sex, age, and height were used in regression analyses. Hypertension was defined as a BP at least 95th centile and prehypertension at least 90th centile. Factors considered in relation to BP included child (BMI, dietary history, socioeconomic status, sedentary behavior) and caregiver measures (BP and caregiver stress). 

    Results: Overall, data from 657 children, aged 2–17 years and their caregivers, collected from 2008 to 2011, were included. Median child age was 6.3 years (interquartile range: 4.0, 9.9); 15.6% (95% confidence interval 12.2–19.1%) had hypertension and 12.3% (9.2–5.5%) prehypertension. Following adjustment, the strongest predictor of BP was caregiver BP (0.15 increase in systolic z-score per 10?mmHg of caregiver BP, 95% confidence interval 0.07–0.24, P?<?0.001); child BMI z-score was significantly related to diastolic [0.08 increase (0.01–0.15) per mg/m BMI increase, P?=?0.03] but not SBP [0.08 increase (−0.01 to 0.16) per mg/m BMI increase, P?=?0.08]. None of the other factors examined were significantly related to BP. 

    Conclusion: BP is frequently elevated in urban aboriginal children. The strongest predictors of BP were caregiver BP and child BMI. Based on these data, and given the strong community linkages of aboriginal people, we recommend family-based interventions to reduce BP in this high-risk group.

    Original languageEnglish
    Pages (from-to)1801-1807
    Number of pages7
    JournalJournal of Hypertension
    Volume35
    Issue number9
    DOIs
    Publication statusPublished - Sep 2017

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    Blood Pressure
    Caregivers
    Prehypertension
    Hypertension
    Confidence Intervals
    Social Adjustment
    Community Health Services
    South Australia
    New South Wales
    Social Class
    Cohort Studies
    Regression Analysis
    Prospective Studies
    Research

    Cite this

    Larkins, N., Teixeira-Pinto, A., Banks, E., Gunasekera, H., Cass, A., Kearnes, J., ... on behalf of the SEARCH investigators (2017). Blood pressure among Australian Aboriginal children. Journal of Hypertension, 35(9), 1801-1807. https://doi.org/10.1097/HJH.0000000000001401
    Larkins, Nicholas ; Teixeira-Pinto, Armando ; Banks, Emily ; Gunasekera, Hasantha ; Cass, Alan ; Kearnes, Jane ; Craig, Jonathan C. ; on behalf of the SEARCH investigators. / Blood pressure among Australian Aboriginal children. In: Journal of Hypertension. 2017 ; Vol. 35, No. 9. pp. 1801-1807.
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    title = "Blood pressure among Australian Aboriginal children",
    abstract = "Objectives: To determine the prevalence of elevated blood pressure (BP) and potential predictors of SBP and DBP in urban Australian aboriginal children. Methods: The Study of Environment on Aboriginal Resilience and Child Health is a prospective cohort study of urban Aboriginal children attending four Aboriginal Community Controlled Health Services in New South Wales, Australia. Clinical measures included a manual BP measured by research officers using standardized protocols. BP z-scores adjusted for sex, age, and height were used in regression analyses. Hypertension was defined as a BP at least 95th centile and prehypertension at least 90th centile. Factors considered in relation to BP included child (BMI, dietary history, socioeconomic status, sedentary behavior) and caregiver measures (BP and caregiver stress). Results: Overall, data from 657 children, aged 2–17 years and their caregivers, collected from 2008 to 2011, were included. Median child age was 6.3 years (interquartile range: 4.0, 9.9); 15.6{\%} (95{\%} confidence interval 12.2–19.1{\%}) had hypertension and 12.3{\%} (9.2–5.5{\%}) prehypertension. Following adjustment, the strongest predictor of BP was caregiver BP (0.15 increase in systolic z-score per 10?mmHg of caregiver BP, 95{\%} confidence interval 0.07–0.24, P?<?0.001); child BMI z-score was significantly related to diastolic [0.08 increase (0.01–0.15) per mg/m BMI increase, P?=?0.03] but not SBP [0.08 increase (−0.01 to 0.16) per mg/m BMI increase, P?=?0.08]. None of the other factors examined were significantly related to BP. Conclusion: BP is frequently elevated in urban aboriginal children. The strongest predictors of BP were caregiver BP and child BMI. Based on these data, and given the strong community linkages of aboriginal people, we recommend family-based interventions to reduce BP in this high-risk group.",
    author = "Nicholas Larkins and Armando Teixeira-Pinto and Emily Banks and Hasantha Gunasekera and Alan Cass and Jane Kearnes and Craig, {Jonathan C.} and {on behalf of the SEARCH investigators}",
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    Larkins, N, Teixeira-Pinto, A, Banks, E, Gunasekera, H, Cass, A, Kearnes, J, Craig, JC & on behalf of the SEARCH investigators 2017, 'Blood pressure among Australian Aboriginal children', Journal of Hypertension, vol. 35, no. 9, pp. 1801-1807. https://doi.org/10.1097/HJH.0000000000001401

    Blood pressure among Australian Aboriginal children. / Larkins, Nicholas; Teixeira-Pinto, Armando; Banks, Emily; Gunasekera, Hasantha; Cass, Alan; Kearnes, Jane; Craig, Jonathan C.; on behalf of the SEARCH investigators.

    In: Journal of Hypertension, Vol. 35, No. 9, 09.2017, p. 1801-1807.

    Research output: Contribution to journalArticleResearchpeer-review

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    AU - Banks, Emily

    AU - Gunasekera, Hasantha

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    AU - Craig, Jonathan C.

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    AB - Objectives: To determine the prevalence of elevated blood pressure (BP) and potential predictors of SBP and DBP in urban Australian aboriginal children. Methods: The Study of Environment on Aboriginal Resilience and Child Health is a prospective cohort study of urban Aboriginal children attending four Aboriginal Community Controlled Health Services in New South Wales, Australia. Clinical measures included a manual BP measured by research officers using standardized protocols. BP z-scores adjusted for sex, age, and height were used in regression analyses. Hypertension was defined as a BP at least 95th centile and prehypertension at least 90th centile. Factors considered in relation to BP included child (BMI, dietary history, socioeconomic status, sedentary behavior) and caregiver measures (BP and caregiver stress). Results: Overall, data from 657 children, aged 2–17 years and their caregivers, collected from 2008 to 2011, were included. Median child age was 6.3 years (interquartile range: 4.0, 9.9); 15.6% (95% confidence interval 12.2–19.1%) had hypertension and 12.3% (9.2–5.5%) prehypertension. Following adjustment, the strongest predictor of BP was caregiver BP (0.15 increase in systolic z-score per 10?mmHg of caregiver BP, 95% confidence interval 0.07–0.24, P?<?0.001); child BMI z-score was significantly related to diastolic [0.08 increase (0.01–0.15) per mg/m BMI increase, P?=?0.03] but not SBP [0.08 increase (−0.01 to 0.16) per mg/m BMI increase, P?=?0.08]. None of the other factors examined were significantly related to BP. Conclusion: BP is frequently elevated in urban aboriginal children. The strongest predictors of BP were caregiver BP and child BMI. Based on these data, and given the strong community linkages of aboriginal people, we recommend family-based interventions to reduce BP in this high-risk group.

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    Larkins N, Teixeira-Pinto A, Banks E, Gunasekera H, Cass A, Kearnes J et al. Blood pressure among Australian Aboriginal children. Journal of Hypertension. 2017 Sep;35(9):1801-1807. https://doi.org/10.1097/HJH.0000000000001401