Essential Arterial Hypertension occurring in Children and Teenagers

Background: Arterial hypertension (AH) manifested during childhood and teenage years has been considered, for a long period of time, as being a rare disease and almost exclusively a secondary one. Within the last 10-15 years, as the diagnosis techniques improved and the research regarding juvenile AH extended, the diagnosis criteria have been reconsidered and as a consequence, the disease has become more frequent until reaching the age of 16, compared to the past periods of time. Aim & Objectives: The research was carried out during the year 2011, within the partnership educational project, Integration through Schools and Anthropology, No. 357/2011. The general objective stated for the anthropological study implied by this project is to examine interand trans-disciplinary certain aspects of the lifestyle of the children and teenagers belonging to rural Roma people communities and its impact on their health, likelihood to develop certain diseases as well as to propose prophylactic measures. Within the general objective framework, for the purpose of this paper I isolated the findings related to the incidence of AH among children and teenagers and I explored its possible relation to the community lifestyle (eating habits, improper housing, family size) and genetic factors (AH family history, precocious appearance of secondary sexual features as a sign of early adulthood). Methods/Study Design: The medical and anthropometrical research was carried out on two groups of students from the rural environment, aged between 10 and 16 years: one control group and an experimental group. The control group was formed of 100 Romanian students, 30% boys and 70% girls. The experimental group, formed of 100 Romanian students from a Roma people rural community, 26% boys, 74% girls. The Roma people rural communities preserve a more archaic lifestyle, including culinary habits, that can influence the incidence of AH. Questionnaires comprising 63 questions were administered for the completion of data regarding their lifestyle. For the statistical comparisons we calculated the Odds Ratio (OR) using CHI Square test with Yates’ correction. Statistical analysis of variance (ANOVA) was used for the characterization of the anthropometric variables. The subjects involved in the research were not diagnosed with kidney, cardiovascular or endocrine diseases or with mental retardation. Study Design: Prospective case-control. International Journal of Collaborative Research on Internal Medicine & Public Health Vol. 4 No. 6 (2012) 1018 Consent: The volunteers were selected after their parents had freely expressed their informed consent in written form. Results/ Findings: The incidence of AH among the participating children and teenagers in both groups is within the limits mentioned in the field literature, 4.00% for the control group and 7.00% for the experimental group. There is a positive association (OR=1.8064), statistically significant (p<0.0166) between AH incidence and the studied group. Most of the subjects from both groups have AH borderline values. All the subjects diagnosed with AH have AH family history. 84.62% of boys in the experimental group eat daily salty foods comparing to 66.66% of the boys in the control group. There is a positive association (OR=1.6666), statistically significant (p<0.0299) between AH incidence and the salt consumption There is a positive association (OR=1.95), statistically insignificant (p<0.1) between AH incidence and the number of children per family. There is a positive association (OR=1.66), statistically significant (p<0.0299) between AH incidence and the presence of secondary sexual characteristics. There are no statistically significant differences (p>0.05) between the two groups regarding the anthropometric variables analyzed pertaining to gender. Conclusion: According to the field scientific literature it is generally accepted that systolic and/or diastolic AH is 3-4 times more frequent among obese children and teenagers comparing to those with normal weight and 6-8 times to underweight ones (1 Gherasim 1996). Nevertheless, the findings of the research presented in this paper indicate that certain particularities of the lifestyle (increased salt consumption, overcrowded and improper dwellings) and certain genetic factors (AH family history, early adulthood) may explain a higher incidence of AH even among normal-weight and underweight children and teenagers.