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<p>Accurately estimating childhood hypertension prevalence is challenging due to blood pressure variability and the need for confirmation across multiple measurements. This study assessed prevalence of hypertension status, stages, and phenotypes among Chinese children on three visits and explored their associations with healthy lifestyles. A school-based cross-sectional survey conducted in Pinghu, Zhejiang province, in September 2022 included 2538 children aged 8–14 years. Elevated blood pressure was defined as blood pressure ≥95th percentile for age, sex, and height in a single measurement, while hypertension required confirmation across three occasions. A healthy lifestyle score was developed based on normal weight, ≥60 min/day of moderate-to-vigorous physical activity, &lt;2 h/day of screen time, adequate sleep, dietary diversity. Multivariable logistic regression assessed associations between healthy lifestyles and hypertension status, stages (stage 1 and stage 2) and phenotypes (isolated systolic hypertension [ISH], isolated diastolic hypertension [IDH], systolic diastolic hypertension [SDH]). Elevated blood pressure prevalence decreased from 16.9% to 4.4% across visits. Prevalence rates were 3.2% for stage 1 hypertension, 1.2% for stage 2&#xa0;hypertension, 2.5% for ISH, 0.4% for IDH, and 1.4% for SDH. Each 1-point increase in healthy lifestyle score, the odds of children being hypertension, stage1 hypertension, stage 2 hypertension, ISH, IDH and SDH decreased by 43% (odds ratio 0.57, 95% confidence interval 0.46–0.70), 44% (0.56, 0.44–0.71), 40% (0.60, 0.41–0.86), 39% (0.61, 0.47–0.80), 49% (0.51, 0.27–0.98) and 48% (0.52, 0.36–0.74), respectively. Prevalence of childhood hypertension among those aged 8–14 years in Pinghu was 4.4%. Adherence to multiple healthy lifestyles was associated with hypertension status, stages, and phenotypes.</p>

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Hypertension in Chinese children: prevalence, phenotypes, stages, and associations with healthy lifestyles from a multi-visit study

  • 期刊论文

  • 发表日期：

    2025年11月25日

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  • Bing Zhu,
  • Shuting Li,
  • Jiali Zhou,
  • Zeyu Luo,
  • Denan Jiang,
  • Longzhu Zhu,
  • Weidi Sun,
  • Shiyi Shan,
  • Ronghua Zhang,
  • Peige Song

摘要

Accurately estimating childhood hypertension prevalence is challenging due to blood pressure variability and the need for confirmation across multiple measurements. This study assessed prevalence of hypertension status, stages, and phenotypes among Chinese children on three visits and explored their associations with healthy lifestyles. A school-based cross-sectional survey conducted in Pinghu, Zhejiang province, in September 2022 included 2538 children aged 8–14 years. Elevated blood pressure was defined as blood pressure ≥95th percentile for age, sex, and height in a single measurement, while hypertension required confirmation across three occasions. A healthy lifestyle score was developed based on normal weight, ≥60 min/day of moderate-to-vigorous physical activity, <2 h/day of screen time, adequate sleep, dietary diversity. Multivariable logistic regression assessed associations between healthy lifestyles and hypertension status, stages (stage 1 and stage 2) and phenotypes (isolated systolic hypertension [ISH], isolated diastolic hypertension [IDH], systolic diastolic hypertension [SDH]). Elevated blood pressure prevalence decreased from 16.9% to 4.4% across visits. Prevalence rates were 3.2% for stage 1 hypertension, 1.2% for stage 2 hypertension, 2.5% for ISH, 0.4% for IDH, and 1.4% for SDH. Each 1-point increase in healthy lifestyle score, the odds of children being hypertension, stage1 hypertension, stage 2 hypertension, ISH, IDH and SDH decreased by 43% (odds ratio 0.57, 95% confidence interval 0.46–0.70), 44% (0.56, 0.44–0.71), 40% (0.60, 0.41–0.86), 39% (0.61, 0.47–0.80), 49% (0.51, 0.27–0.98) and 48% (0.52, 0.36–0.74), respectively. Prevalence of childhood hypertension among those aged 8–14 years in Pinghu was 4.4%. Adherence to multiple healthy lifestyles was associated with hypertension status, stages, and phenotypes.