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Arterial hypertension in school-aged children in western Romania

  • Adela Chirita-Emandi (a1) (a2), Maria Puiu (a2) (a3), Mihai Gafencu (a1) (a2) and Corina Pienar (a1) (a2)

To describe the current prevalence of paediatric hypertension and the relationships between body mass index, gender, place of residence, and blood pressure in a population of school-aged children from western Romania.

Material and method

A total of 3626 children from Timisoara and the surrounding regions were examined by medical students from February, 2010 to June, 2011. Children's body mass index was interpreted on the basis of reference guidelines from Centers for Disease Control and Prevention. Blood pressure measurements were taken by the auscultation method. For defining elevated blood pressure, we used the standards published in the Fourth Report.


Overall, the prevalence of overweight was 14% and 11.8% for obesity. Boys had a higher prevalence of both overweight and obesity compared with girls. The prevalence of hypertension on our screening was 9.1% higher in boys and urban residence. The prevalence of pre-hypertension was 6.5%. With regard to body mass index, 21.1% of obese, 12.8% of overweight, and 7.1% of normal weight children presented hypertension. The strongest determinant of hypertension was body mass index percentile. Significant odds ratio was found for obesity (3.93; confidence interval: 3.11–4.95), urban residence (1.68; confidence interval: 1.35–2.1), and male gender (1.34; confidence interval: 1.12–1.6).


The results confirm a worrisome prevalence of overweight and obesity among children in Romania, accompanied by an alarming prevalence of hypertension. Overweight and obesity, male gender, and urban residence were the major contributing factors for the overall high prevalence of hypertension found. Our results point to the urgent need to adopt strategies aimed at preventing hypertension and obesity in children in Romania.

Corresponding author
Correspondence to: Dr A. Chirita-Emandi, MD, PhD Student, Department of Endocrinology, Emergency Hospital for Children “Louis Turcanu”, Street Iosif Nemoianu number 2, 300011 Timisoara, Romania. Tel: +0040724369599; Fax: +0040256497818; E-mail:
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1. BASwinburn , GSacks , KDHall , et al. The global obesity pandemic: shaped by global drivers and local environments. Lancet 2011; 378: 804814.

2.Y Wang , T Lobstein . Worldwide trends in childhood overweight and obesity. Int J Pediatr Obes 2006; 1: 1125.

3. DSFreedman , PTKatzmarzyk , WHDietz , SRSrinivasan , GSBerenson . Relation of body mass index and skinfold thickness to cardiovascular disease risk factors in children: the Bogalusa Heart Study. Am J Clin Nutr 2009; 90: 210216.

4.GS Berenson . Health consequences of obesity. Pediatric Blood & Cancer 2012; 58: 117121.

5.V Kotsis , S Stabouli , S Papakatsika , Z Rizos , G Parati . Mechanisms of obesity-induced hypertension. Hypertens Res 2010; 33: 386393.

6. KBibbins-Domingo , PCoxson , MJPletcher , JLightwood , LGoldman . Adolescent overweight and future adult coronary heart disease. N Engl J Med 2007; 357: 23712379.

7.P Muntner , J He , JA Cutler , RP Wildman , PK Whelton . Trends in blood pressure among children and adolescents. J Am Med Assoc 2004; 291: 21072113.

8.R Din-Dzietham , Y Liu , M-V Bielo , F Shamsa . High blood pressure trends in children and adolescents in national surveys, 1963 to 2002. Circulation 2007; 116: 14881496.

9.A Chiolero , P Bovet , G Paradis , F Paccaud . Has blood pressure increased in children in response to the obesity epidemic? Pediatrics 2007; 119: 544553.

10.M Flechtner-Mors , M Thamm , S Wiegand et al. Comorbidities related to body mass index category in children and adolescents: German/Austrian/Swiss Obesity Register APV compared to the German KiGGS Study. Hormone Research in Paediatrics, 2011: published online. Available from

11.R Bancalari , C Díaz , A Martínez-Aguayo , et al. Prevalence of hypertension in school age children and its association with obesity. Rev Med Chil 2011; 139: 872879.

12. CPileggi , VCarbone , CGANobile , MPavia . Blood pressure and related cardiovascular disease risk factors in 6–18 year-old students in Italy. J Paediatr Child Health 2005; 41: 347352.

13.A Ivan , R Duda , M Groll , et al. Epidemiology of essential arterial hypertension in collectives of schoolchildren. The prevalence of blood pressure changes. Rev Pediatr Obstet Ginecol Pediatr 1989; 38: 247254.

16. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 2004; 114 (2 Suppl, 4th Report): 555–576.

17.JA Clark , MW Lieh-Lai , A Sarnaik , TK Mattoo . Discrepancies between direct and indirect blood pressure measurements using various recommendations for arm cuff selection. Pediatrics 2002; 110: 920923.

19.VA Kovács , A Gábor , Z Fajcsák , E Martos . Sport habits and sedentary lifestyle among elementary school children in Obuda, Hungary. Orv Hetil 2010; 151: 652658.

20.D Kisić-Tepavcević , N Jovanović , V Kisić , et al. The prevalence of childhood obesity in a sample of schoolchildren in Belgrade. Srp Arh Celok Lek 2008; 136: 621624.

21. ECacciari , SMilani , ABalsamo , et al. Italian cross-sectional growth charts for height, weight and body mass index (2 to 20 yr). J Endocrinol Invest 2006; 29: 581593.

22.Z Mészáros , J Mészáros , E Völgyi , et al. Body mass and body fat in Hungarian schoolboys: differences between 1980–2005. Journal of Physiological Anthropology 2008; 27: 241245.

23.MN Lutfiyya , MS Lipsky , J Wisdom-Behounek , M Inpanbutr-Martinkus . Is rural residency a risk factor for overweight and obesity for U.S. Children? Obesity 2007; 15: 23482356.

24. DBReed , PJPatterson , NWasserman . Obesity in rural youth: looking beyond nutrition and physical activity. J Nutr Educ Behav 2011; 43: 401408.

25.LK Twells , LA Newhook . Obesity prevalence estimates in a Canadian regional population of preschool children using variant growth references. BMC Pediatr 2011; 11: 21.

26. ARMarras , PPBassareo , MRuscazio . The prevalence of paediatric hypertension, emphasising the need to use specific population references: the Sardinian Hypertensive Adolescents Research Program study. Cardiol Young 2009; 19: 233238.

27. MDSinha , CJReid . At what level of blood pressure should hypertension be defined in children? Cardiol Young 2009: 428430.

28. CLOgden , KMFlegal , MDCarroll , CLJohnson . Prevalence and trends in overweight among US children and adolescents, 1999–2000. J Am Med Assoc 2002; 288: 17281732.

29.JM Sorof , D Lai , J Turner , T Poffenbarger , RJ Portman . Overweight, ethnicity, and the prevalence of hypertension in school-aged children. Pediatrics 2004; 113: 475482.

30.SJ Olshansky , DJ Passaro , RC Hershow , et al. A potential decline in life expectancy in the United States in the 21st century. N Engl J Med 2005; 352: 11381145.

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Cardiology in the Young
  • ISSN: 1047-9511
  • EISSN: 1467-1107
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