Document Type : Original Article(s)

Authors

1 Assistant Professor, Neonatal and Children's Health Research Center, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran

2 Assistant professor, Pediatric Cardiologist, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran

3 Associate Professor, Health Management and Social Development Research Center AND Department of Biostatistics and Epidemiology, School of Health, Golestan University of Medical Sciences, Gorgan, Iran

4 Neonatal and Children's Health Research Center, Taleghani Hospital, Golestan University of Medical Sciences, Gorgan, Iran

Abstract

BACKGROUND: Childhood obesity and hypertension (HTN) are among serious global health concerns. Since risk factors of cardiovascular diseases (CVDs) should be managed early in life and there is little information about children under the age of 6 in the community, the study was designed aiming to address these issues.METHODS: This cross-sectional study was performed on 1,091, 3-6-year-old children in Gorgan City, located in north of Iran. Height, weight, body mass index (BMI), and blood pressure were measured using standard techniques. All statistical tests were conducted using the Statistical Package for the Social Sciences (SPSS) for windows.RESULTS: Given the study, respectively 3.8 and 4.5% of the boys and girls were underweight, 17.4 and 16.5% of the boys and girls were overweight, and 20.8 and 19.3% of the boys and girls were obese. In addition, 3.4, 0.7, and 0.4% of the subjects had presystolic, systolic, and prediastolic HTN, respectively. There is a significant linear relationship between BMI and systolic and diastolic blood pressures. It was found that the risk of obesity in mothers with college education was estimated to be almost 5 times higher than in mothers with lower levels of education.CONCLUSION: Compared to the values announced by Centers for Disease Control and Prevention (CDC), the mean height, weight, and BMI of children in our study was higher. Educational interventions should be considered in society, especially for mothers with a high level of education and employed ones. It is recommended that blood pressure measurements, especially in obese children, be carefully considered at each pediatric visit so that children with HTN could be quickly identified and treated.

Keywords

  1. Kelishadi R, Pour MH, Sarraf-Zadegan N, Sadry GH, Ansari R, Alikhassy H, et al. Obesity and associated modifiable environmental factors in Iranian adolescents: Isfahan Healthy Heart Program - Heart Health Promotion from Childhood. Pediatr Int 2003; 45(4): 435-42.
  2. Gehani AA, Al-Hinai AT, Zubaid M, Almahmeed W, Hasani MR, Yusufali AH, et al. Association of risk factors with acute myocardial infarction in Middle Eastern countries: The Interheart Middle East study. Eur J Prev Cardiol 2014; 21(4): 400-10.
  3. Ide N, Thompson M. Screening children for hypertension: The case against. Pediatr Nephrol 2018; 33(1): 93-100.
  4. Binka E, Brady TM. Real-world strategies to treat hypertension associated with pediatric obesity. Curr Hypertens Rep 2019; 21(2): 18.
  5. Wang J, Zhu Y, Jing J, Chen Y, Mai J, Wong SH, et al. Relationship of BMI to the incidence of hypertension: A 4 years' cohort study among children in Guangzhou, 2007-2011. BMC Public Health 2015; 15: 782.
  6. Oner N, Vatansever U, Sari A, Ekuklu E, Guzel A, Karasalihoglu S, et al. Prevalence of underweight, overweight and obesity in Turkish adolescents. Swiss Med Wkly 2004; 134(35-36): 529-33.
  7. Skinner AC, Ravanbakht SN, Skelton JA, Perrin EM, Armstrong SC. Prevalence of obesity and severe obesity in US children, 1999-2016. Pediatrics 2018; 141(3): e20173459.
  8. Heidari-Beni M, Kelishadi R. Prevalence of weight disorders in Iranian children and adolescents. Arch Iran Med 2019; 22(9): 511-5.
  9. Ebrahimi H, Emamian MH, Hashemi H, Fotouhi A. Prevalence of prehypertension and hypertension and its risk factors in Iranian school children: A population-based study. J Hypertens 2018; 36(9): 1816-24.
  10. Esteghamati A, Khalilzadeh O, Mohammad K, Meysamie A, Rashidi A, Kamgar M, et al. Secular trends of obesity in Iran between 1999 and 2007: National Surveys of Risk Factors of Non-communicable Diseases. Metab Syndr Relat Disord 2010; 8(3): 209-13.
  11. Gies I, AlSaleem B, Olang B, Karima B, Samy G, Husain K, et al. Early childhood obesity: A survey of knowledge and practices of physicians from the Middle East and North Africa. BMC Pediatr 2017; 17(1): 115.
  12. Jafari-Adli S, Jouyandeh Z, Qorbani M, Soroush A, Larijani B, Hasani-Ranjbar S. Prevalence of obesity and overweight in adults and children in Iran; a systematic review. J Diabetes Metab Disord 2014; 13(1): 121.
  13. Hajian-Tilaki KO, Sajjadi P, Razavi A. Prevalence of overweight and obesity and associated risk factors in urban primary-school children in Babol, Islamic Republic of Iran. East Mediterr Health J 2011; 17(2): 109-14.
  14. Dorosty AR, Siassi F, Reilly JJ. Obesity in Iranian children. Arch Dis Child 2002; 87(5): 388-91.
  15. Armoon B, Karimy M. Epidemiology of childhood overweight, obesity and their related factors in a sample of preschool children from Central Iran. BMC Pediatr 2019; 19(1): 159.
  16. Kelishadi R, Ardalan G, Gheiratmand R, Majdzadeh R, Hosseini M, Gouya MM, et al. Thinness, overweight and obesity in a national sample of Iranian children and adolescents: CASPIAN Study. Child Care Health Dev 2008; 34(1): 44-54.
  17. Wuhl E. Hypertension in childhood obesity. Acta Paediatr 2019; 108(1): 37-43.
  18. Zhang Q, Yang L, Zhang Y, Zhao M, Liang Y, Xi B. Hypertension prevalence based on three separate visits and its association with obesity among chinese children and adolescents. Front Pediatr 2019; 7: 307.
  19. Sabri M, Gheissari A, Mansourian M, Mohammadifard N, Sarrafzadegan N. Essential hypertension in children, a growing worldwide problem. J Res Med Sci 2019; 24: 109.
  20. Basiratnia M, Derakhshan D, Ajdari S, Saki F. Prevalence of childhood obesity and hypertension in south of Iran. Iran J Kidney Dis 2013; 7(4): 282-9.
  21. Kelishadi R, Ardalan G, Gheiratmand R, Ramezani A. Is family history of premature cardiovascular diseases appropriate for detection of dyslipidemic children in population-based preventive medicine programs? CASPIAN study. Pediatr Cardiol 2006; 27(6): 729-36.
  22. Kelishadi R, Ardalan G, Gheiratmand R, Majdzadeh R, Delavari A, Heshmat R, et al. Blood pressure and its influencing factors in a national representative sample of Iranian children and adolescents: the CASPIAN Study. Eur J Cardiovasc Prev Rehabil 2006; 13(6): 956-63.
  23. Kelishadi R, Cook SR, Motlagh ME, Gouya MM, Ardalan G, Motaghian M, et al. Metabolically obese normal weight and phenotypically obese metabolically normal youths: the CASPIAN Study. J Am Diet Assoc 2008; 108(1): 82-90.
  24. Yilmaz M, Aktas B, Dereli F, Sari HY, Kundakçi GA, Tiryaki Z. Assessment of the prevalence of obesity, stunting, and hypertension among primary school children. Eur J Ther 2017; 23(3): 99-105.
  25. Badeli H, Hassankhani A, Naeemi Z, Hosseinzadeh S, Mehrabi S, Pourkarimi M, et al. Prevalence of hypertension and obesity-related hypertension in urban school-aged children in Rasht. Iran J Kidney Dis 2016; 10(6): 364-8.
  26. Tabesh H, Hosseiny SM, Kompani F, Saki A, Firoozabadi MS, Chenary R, et al. Prevalence and trend of overweight and obesity among schoolchildren in Ahvaz, Southwest of Iran. Glob J Health Sci 2013; 6(2): 35-41.
  27. Kalantari N, Doaei S, Keshavarz-Mohammadi N, Gholamalizadeh M, Pazan N. Review of studies on the fat mass and obesity-associated (FTO) gene interactions with environmental factors affecting on obesity and its impact on lifestyle interventions. ARYA Atheroscler 2016; 12(6): 281-90.
  28. Centers for Disease Control and Prevention (CDC). Individual Growth Charts, 2000 [Online]. [cited 2009 Aug 4]; Available from: URL: https://www.cdc.gov/growthcharts/charts.htm
  29. Kliegman RM, Behrman RE, Jenson HB, Stanton BM. Nelson textbook of pediatrics e-book. Philadelphia, PA: Elsevier Health Sciences; 2020.
  30. Luma GB, Spiotta RT. Hypertension in children and adolescents. Am Fam Physician 2006; 73(9): 1558-68.