Blood pressure and body mass index in an ethnically diverse sample of adolescents in Paramaribo, Suriname

<p>Abstract</p> <p>Background</p> <p>High blood pressure (BP) is now an important public health problem in non-industrialised countries. The limited evidence suggests ethnic inequalities in BP in adults in some non-industrialised countries. However, it is unclear whether these ethnic inequalities in BP patterns in adults reflect on adolescents. Hence, we assessed ethnic differences in BP, and the association of BP with body mass index (BMI) among adolescents aged 12–17 years in Paramaribo, Suriname.</p> <p>Methods</p> <p>Cross-sectional study with anthropometric and blood pressure measurements. A random sample of 855 adolescents (167 Hindustanis, 169 Creoles, 128 Javanese, 91 Maroons and 300 mixed-ethnicities) were studied. Ethnicity was based on self-reported ethnic origin.</p> <p>Results</p> <p>Among boys, Maroons had a lower age- and height-adjusted systolic BP than Creoles, and a lower diastolic BP than other ethnic groups. However, after further adjustment for BMI, only diastolic BP in Maroons was significantly lower than in Javanese (67.1 versus 70.9 mmHg). Creole boys had a lower diastolic BP than Hindustani (67.3 versus 70.2 mmHg) and Javanese boys after adjustment for age, height and BMI. Among girls, there were no significant differences in systolic BP between the ethnic groups. Maroon girls, however, had a lower diastolic BP (65.6 mmHg) than Hindustani (69.1 mmHg), Javanese (71.2 mmHg) and Mixed-ethnic (68.3 mmHg) girls, but only after differences in BMI had been adjusted for. Javanese had a higher diastolic BP than Creoles (71.2 versus 66.8 mmHg) and Mixed-ethnicity girls. BMI was positively associated with BP in all the ethnic groups, except for diastolic BP in Maroon girls.</p> <p>Conclusion</p> <p>The study findings indicate higher mean BP levels among Javanese and Hindustani adolescents compared with their African descent peers. These findings contrast the relatively low BP reported in Javanese and Hindustani adult populations in Suriname and underscore the need for public health measures early in life to prevent high BP and its sequelae in later life.</p

The use of the waiting list in a fair selection of patients for nursing home care

When health care resources are scarce, waiting lists may be used as a distribution measure in order to enhance the fair allocation of resources through selection of patients. In this study, the structure and use of a waiting list for a fair selection of patients for nursing home admission was studied. Qualitative research took place in two regions in the Netherlands, where scarcity exists in nursing home care. Selection meetings were attended and 39 health care workers were interviewed. Not only did waiting list criteria like urgency and chronology determine the final selection decision, but also efficiency and quality of care considerations (patients' preferences for particular nursing homes and nursing homes' considerations of matching the unit and work load). These considerations, their relative importance, and the resulting need for enforcement of the decision-making procedures, should be part of the discussion of patient selection. This acknowledges the complexity of the selection of patients

Relationship Between Asthma and High Blood Pressure Among Adolescents in Aracaju, Brazil

Background. Asthma has been linked to cardiovascular diseases (CVDs) and related risk factors such as hypertension in adults. It is unclear whether the relationship between asthma and hypertension found among adults is also observed in adolescents. Hence, the authors examined asthma and its association with prehypertension and hypertension among adolescents in Aracaju, Brazil. Methods. Data on asthma and blood pressure were collected among 1002 adolescents age 12 to 17 years old in 15 public schools, 5 municipal schools, and 10 private schools. Asthma data were ascertained by the International Study of Asthma and Allergies in Childhood (ISAAC) written questionnaire. Sex-, age-, and height-specific percentile levels were used to define prehypertension (90-94th percentile) and hypertension (>= 95(th) percentile). Results. the prevalence of asthma was 20.6% in boys and 27.7% in girls. Among boys, the prevalence rates of prehypertension and hypertension were 26.7% and 17.0%, respectively. Among girls, the rates of prehypertension and hypertension were 14.3% and 12.9%, respectively. There were no statistically significant associations between asthma and prehypertension, and hypertension, even after adjusting for age, social economic status, physical activity, and body mass index (BMI) in both boys (prehypertension: odds ratio [OR] = 1.35, 95% confidence interval [CI]: 0.80-2.27; hypertension: OR = 0.60, 95% CI: 0.29-1.23) and girls (prehypertension: OR = 0.71, 95% CI: 0.40-1.28; hypertension: OR = 1.07, 95% CI: 0.60-1.94). Conclusions. These results suggest no association between asthma and high blood pressure in adolescents. More prospective studies are needed to establish whether hypertension becomes more pronounced at a specific age in asthmatics, and if so, the possible factors that may contribute to this.Univ Amsterdam, Acad Med Ctr, Dept Publ Hlth, NL-1105 AZ Amsterdam, NetherlandsUniv Fed Sergipe, Dept Med & Post Grad Nucleus Med, Aracaju, BrazilUniv Fed Sergipe, Univ Hosp, Aracaju, BrazilUniversidade Federal de São Paulo, Dept Paediat, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Paediat, São Paulo, BrazilWeb of Scienc

Blood pressure and BMI in adolescents in Aracaju, Brazil

Objective: To assess the prevalence of high blood pressure (BP) and the association of overweight and obesity with high BP among adolescents in Aracaju, Brazil. Design: Cross-sectional study. The main outcome measure was the proportion of adolescents with high BP (sex-, age- and height-specific >= 95th percentile). The main predictor variables were overweight and obesity defined according to the criteria of the International Obesity Task Force. Other covariates included age, socio-economic status and leisure-time physical activity. Setting: Aracaju, Brazil, capital city of Sergipe State, north-eastern Brazil. Subjects: A random sample of 1002 adolescents (442 boys and 560 girls) aged 12-17 years selected from twenty public schools and ten private schools were studied. Results: The prevalence of high BP was 16.9% (95% CI 13.1, 21.7) in boys and 12.9% (95% CI 9.0, 18.0) in girls. After adjusting for age, socio-economic status and leisure-time physical activity in both boys and girls, overweight (prevalence ratio (PR) 51.93, 95% CI 1.08, 3.48; PR = 4.34, 95% CI 2.58, 7.30, respectively) and obesity (PR = 4.87, 95% CI 2.35, 10.11; PR = 5.18, 95% CI 2.67, 10.06, respectively) were found to be associated with high BP. Conclusions: These findings indicate a high prevalence of high BP in both boys and girls in Aracaju, Brazil. Overweight and obesity were strongly associated with high BP. These findings underscore the urgent need for public health measures to prevent increasing high BP in adolescents in Brazil. Targeting intervention in adolescence may be a critical method for preventing high BP in later lif