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(Circulation. 2009;119:558-565.)
© 2009 American Heart Association, Inc.

Pediatric Cardiology

Discordant Secular Trends in Elevated Blood Pressure and Obesity in Children and Adolescents in a Rapidly Developing Country

Arnaud Chiolero, MD, MSc; Gilles Paradis, MD, MSc; Georges Madeleine, RN; James A. Hanley, PhD; Fred Paccaud, MD, MSc; Pascal Bovet, MD, MPH

From the Institute of Social and Preventive Medicine, University Hospital Center and University of Lausanne, Lausanne, Switzerland (A.C., F.P., P.B.); Department of Epidemiology, Biostatistics, and Occupational Health (A.C., G.P., J.A.H.) and Health Center Research Institute (G.P.), McGill University, Montreal, Quebec, Canada; and Ministry of Health and Social Development, Victoria, Republic of Seychelles (G.M., P.B.).

Correspondence to Dr Pascal Bovet, Institute of Social and Preventive Medicine, University of Lausanne, 17 Rue du Bugnon, 1005 Lausanne, Switzerland. E-mail pascal.bovet{at}chuv.ch

Received June 3, 2008; accepted November 14, 2008.

Background— The effect of the increasing prevalence of obesity on blood pressure (BP) secular trends is unclear. We analyzed BP and body mass index secular trends between 1998 and 2006 in children and adolescents of the Seychelles, a rapidly developing island state in the African region.

Methods and Results— School-based surveys were conducted annually between 1998 and 2006 among all students in 4 school grades (kindergarten and 4th, 7th, and 10th years of compulsory school). We used the Centers for Disease Control and Prevention criteria to define obesity and elevated BP. The same methods and instruments were used in all surveys. Some 25 586 children and adolescents 4 to 18 years of age contributed 43 867 observations. Although the prevalence of obesity in boys and girls increased from 5.1% and 6.0%, respectively, in 1998 to 2000 to 8.0% and 8.7% in 2004 to 2006, the prevalence of elevated BP decreased from 8.4% and 9.8% to 6.9% and 7.8%. During the interval, mean age-adjusted body mass index increased by 0.57 kg/m² in boys and 0.58 kg/m² in girls. Mean age- and height-adjusted systolic BP decreased by –3.0 mm Hg in boys and –2.8 mm Hg in girls, whereas mean diastolic BP did not change substantially in boys (–0.2 mm Hg) and increased slightly in girls (0.4 mm Hg).

Conclusion— At a population level, the marked increase in the prevalence of obesity in children and adolescents in the Seychelles was not associated with a commensurate secular rise in mean BP.

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