الفهرس 
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Abstract
Pediatric hypertension is a field of increasing interest and
importance. The identification of children at risk for hypertension is
important to prevent the serious complications associated with the
condition
Hypertension at childhood is significantly associated with
increased risk of end-organ damage including ventricular hypertrophy
and increased carotid intima–media thickness.
National surveys conducted periodically are necessary to
provide updated information for development of effective programs
and strategies to prevent and control hypertension. The development
of a national database on normative BP levels throughout childhood
has contributed to the recognition of elevated BP in children and
adolescents. The epidemic of childhood obesity, the risk of developing
left ventricular hypertrophy, and evidence of the early development of
atherosclerosis in children would make the detection of and
intervention in childhood hypertension important to reduce long-term
health risks.
According to the National High Blood Pressure Education
Program (NHBPEP) recommendations, children three years of age or
older should have their blood pressure measured when seen at a
medical facility. The preferred method for blood pressure
measurement is auscultation
Measuring BP during childhood is of particular interest because
it may be possible to identify those individuals with early essential
hypertension or those at high risk for the development of sustained
essential hypertension later in life.
The prevalence of pediatric hypertension has increased as a
result of the increasing prevalence of obesity in the pediatric
population
Obesity is an important factor in children with higher values of
BP. Children with high BP are more likely to come from families with
history of hypertension
The identification of such risk factors in children is an
important contribution to the prevention of cardiovascular disease in
adulthood.
So, the aim of the present study was to determine prevalence of
high blood pressure among primary school children in the city of
Bilqas, Dakahlia governorate. This was achieved through a survey
study conducted on 500 primary school children attending public and
private schools located in the urban area of the city of Bilqas,
Dakahlia governorate with age between 6 and 12 years.
All studied children were subjected to:
1. Complete history including family history of hypertension or
diabetes
2. Clinical examination stressing on BP measuring and
anthropometric measurements;
3. Children who found to be hypertensive after three separate
measurements, were subjected to:
Urine analysis.
Serum creatinine.
Blood urea nitrogen.
Lipid profile
In the present study, the demographic characteristics of
the studied children was shown that they had a mean age of 9.1 ± 1.6
years. They included 276 males (55.2 %) and 224 females (44.8).
The studied students were normal in weight in 421 cases
(84.2%), overweight in 49 cases (9.8%) and obese in 30 cases (6.0%)
it was found that 398 children (79.6 %) were normal while 54 (10.8%)
were prehypertensive and 48 (9.6 %) were hypertensive in the first
screening. In the second screening, 55 children (11.0 %) were normal
while 12 children (2.4 %) were prehypertensive and 35 children
(7.0%) were hypertensive. In the third screening, 12 children (2.4 %)
were found normal, 5 children (1.0 %) were prehypertensive and 20
children (4.0 %)were hypertensive.
In conclusion, the prevalence of hypertention in the present
study was 4.0 %.
In the present study, it was found that 4 patients (20.0 %) had
primary causes of hypertension while 16 patients (80.0 %) had
secondary causes of hypertension.
In the current study, 1.8 % of males and 3.1% of females have
systolic hypertension. 0.7% of males and 1.8 % of females have
diastolic hypertension. While both systolic and diastolic hypertensions
were present in 0.4% of males and .5 % of females.
There was also significant positive correlation between systolic
and diastolic blood pressure with weight and BMI .
Regarding the urinary profile in the investigated hypertensive
group (n =20), pyuria was found in 7 children, albuminuria was found
in 4 child, and crystalluria was found in 14 children. it was found that
they had a mean creatinine of 1.6 ± 0.9.
from this study, we can conclude that there are hypertension
patients among primary school children and obesity is a strong
predisposing factor for development of hypertension.
We recommend paying more attention to the importance of
periodic BP measurements for early detection of the disease. We also
recommend improvement of health related behaviors with a focus on
promotion of activity in children specially the more vulnerable
overweight group.