Blood Pressure Assessment in Undergraduate Medical Students: Impact of Gender, Body Mass Index and Family History of Hypertension

Amjed Hassan Abbas,Samir Swadi Hamoud,Shahlaa Khaza,al Chabuk
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Keywords : gender; students; body mass index; prehypertension; hypertension; systolic blood pressure; diastolic blood pressure.
Medical Journal of Babylon  13:2 , 2016 doi:1812-156X-13-2
Published :09 September 2016

Abstract

Increase blood pressure is considered to be a silent killer which lead to increase in morbidity and mortality, so it is necessary to determine the subjects with high risk at an early stage in order to inhibit the disease progression and its co-morbid conditions. This study aimed to measure the blood pressure of undergraduate medical students and its relation to specific risk factors (gender, body mass index and family history of hypertension). The study was performed in College of Medicine in Babylon University in the period from December 2014 to April 2015 and included 330 students. Some variables were taken from the history in addition to measurement of weight, height, systolic and diastolic blood pressure. The results revealed that regarding systolic blood pressure, 15% of students had prehypertension and 8% of students were hypertensive while for diastolic blood pressure, 32% had prehypertension and 4% were hypertensive. There was significant correlation between systolic and diastolic blood pressure with male gender, body mass index and family history of hypertension (P ? 0.05).This study revealed high prevalence of prehypertension and in less extent hypertension among college students and this problem represented a neglected issue.

Introduction

Hypertension is considered as a chronic condition causing a major public health problem producing a challenge to population in socioeconomic and demographic transition. Prehyper-tension in young age group is an important risk for developing hypertension in later years of life[1,2]. The hypertension was common in both developed (333 million) and developing (639 million) countries[3]. There was a strong relation between the increase in blood pressure (BP) in young adults with the increase in mortality from cardiovascular disease in later life, so decrease in blood pressure in young age group could underlie declines in mortality from cardiovascular disease[4].The examination of blood pressure patterns in young age group (that is not caused by diseases, used of drugs, or behavioral changes) will be helpful in explanation of population determinants of blood pressure[5]. In a study performed in Basrah in Iraq, it revealed that the mortality rate due to cardiovascular disease was elevated in the last four decades, which may be related to many risk factors like hypertension so this require information about BP distribution in young people[6]. The present study focuses on the distribution of systolic and diastolic BP in young age group in addition to study the effect of some risk factors on it and this depended upon the hypothesis that early identification of individuals at risk can help in promoting preventive measures as early as possible, so theaim of this study was to assess the pattern of blood pressure distribution among students of medical college of Babylon University in Iraq and its relation to specific risk factors (gender, body mass index and family history of hypertension).

Materials and methods

The study was performed in College of Medicine in Babylon University, it included students from first to six stages, data collected through questionnaires. Field part of the study extended from December 2014 to April 2015.
Data collected included age, gender, family history of hypertension, height, weight, and blood pressure.The body mass index (BMI) was calculated by dividing weight in kilograms by square of height in meters  (kg/m2). It is classified as follows:
under-weight<18.5 kg/m2, normal weight=18.5-24.9 kg/m2, overweight=25-29.9 kg/m2, obesity ? 30 kg/m2[7].
The measurement of blood pressure was performed by mercurial sphygmo-manometer. The measurement were taken after rest for 5 minutes in a sitting position. The heard of the first sound (Korotkoff phase 1) was considered as the systolic BP, while the disappearance of the sound (Korotkoff phase 5) was regarded as the diastolic BP.Blood pressure was classified into four classes: normal BP if the measured systolic BP was <120 mmHg and/or diastolic BP was <80 mmHg; pre-hypertension if the measured systolic BP was 120-139 mmHg and/ or diastolic BP was 80-89 mmHg; stage (1) hypertension if the systolic BP was 140-159 mmHg and/or diastolic BP was 90-99 mmHg; and stage (2) hypertension if the measured systolic blood pressure was ?160 mmHg and/or diastolic blood pressure was ? 100 mmHg[8].
Statistical Analysis
   The collected data were statistically analyzed using SPSS programme [Statistical Package for Social Sciences version 18] . Descriptive statistics were presented by percentage, mean and standard deviation (SD). Groups were compared by using t-test and Chi-square test, a P-value ?0.05 was regarded statistically significant




Results

The study included 330 students (145 males and 185 females), the age ranged from 18-24 years old with mean (20.52±1.2 years). Regarding family history of hypertension there was 146 students with positive family history while there was 184 with negative family history. 1. Distribution of body mass index The predominant percentage of students had normal body mass index as illustrated in figure(1). 2. Distribution of systolic blood pressure The percentage of students with normal systolic B Prepresented the highest percentage(77%), 15% prehypertension and only 8% had hypertension as shown in figure (2). 3. Distribution of diastolic blood pressure Figure (3) shows that normal diastolic blood pressure (64%), prehypertension (32%)and only 4% had hypertension. 4. Frequency distribution of study groups by gender according to body mass index This study revealed that there was significant relation between gender and body mass index (P value?0.05), the percentage of overweight and obesity was higher in males than females as shown in table (1)

Discussions

The problem of hypertension affects about 20-30% of the population. The prevalence is less in young than older population [7]. In our study, the percentage of students with hypertension was 8% for systolic and 4% for diastolic blood pressure. This rate of prevalence was in agreement with the prevalence found in the China [8] and in Korea[9]. The percentage of systolic pre-hypertension was 15% while it was32% for diastolic pre-hypertension and this may give a clue that in the future, many of those subjects might develop overt hypertension. The underweight was more prevalent in females than males were while overweight and obesity were more in males than females and this was consistent with other studies like Silva, et al, [10] and Rahmanian and Shojaie [11]. Gender differences in dietary habits and lifestyles could be the causes for the observed differences between male and female subjects. The high incidence of underweight in the female subjects may be attributed to the ‘slim-fit’ syndrome among young modern women. Most women in this age range are excessively concerned about their shape and make purposeful efforts to maintain a trim shape, as a result of poor eating habits, the women end up being malnourished[12]. In this study the prehypertension and hypertension (systolic and diastolic) increased significantly with BMI and family history of hypertension with higher values in males than in females and this was consistent with other studies as in a study performed by [13]. The classification of body weight according to BMI was due to the fact that it represents an index that has an important explanatory power concerning the occurrence of arterial hypertension[14]. The percentage of prehypertension and hypertension was more in group of students with multiple risk factors (male gender, increased body weight and positive family history of hypertension) than other groups. This finding was consist with Weil, et al, who referred to impaired nitric oxide-mediated-endothelium-dependent vasodilation, this will lead to vasoconstriction and this make possible elevation of BP[15].

Conclusions

Prehypertension and hypertension were regarded as an important public-health problem among college students. Systolic and diastolic BP was higher in male students than in female students. The results also showed that gender, BMI and positive family history of hypertension were important effectors in case of increase in blood pressure.

References

1. Kearney, P., Whelton, M., Reynolds K., Muntner, P., Whelton, P. and He, J. (2005). Global burden of hypertension: analysis of worldwide data. Lancet.; 365 (9455): 217–223.
2. Ostchega, Y., Dillon, C., Hughes, J.P., Carroll, M., and Yoon, S. (2007). Trends in hypertension prevalence, awareness, treatment, and control in older U.S. adults: data from the National Health and Nutrition Examination Survey 1988 to 2004". Journal of the American Geriatrics Society; 55 (7): 1056–1065.
3. Hajjar, I. and Kotchen, T. (2003). Trends in prevalence, awareness, treatment and control of hypertension in U.S. JAMA; 290(2): 199-206.
4. Sung, S., Cheng, H., Wang, K., Yu,W., Chuang, S. and Ting, C. (2013). White coat hypertension is more risky than prehypertension: Important role of arterial wave reflections. Hypertension; 61:1346–1353.
5. Gregory, B., Luma, G. and Spiotta, T. (2006). Hypertension in Children and Adolescents. American Academy of Family Physician; 5(2): 45.
6. Abdul-Hussein, F., Ghadhban, M. and Omran, S. (2011). A study on the distribution of blood pressure measurements among university students. MJBU; 29(2): 119.
7. Wenyue, P., Zhaoqing, S., Liqiang, Z. and Jue, L. (2008). Body Mass Index and the Prevalence of Prehypertension and Hypertension in a Chinese Rural Population. Inter Med 47(6): 893-897.
8. Guang, Y., Yue, M. and Shibin, W. (2015). Prevalence and correlates of prehypertension and hypertension among adults in northeastern China: a cross-sectional study. Academic Editor: Paul B. Tchounwou; 12 (5): 102.
9. Jo, I., Ahn, Y., Lee, J., Shin, K., Lee, H. and Shin, C. (2001). Prevalence, awareness, treatment, control and risk factor of hypertension in Korea. J. Hypertension; 19(9): 1523-1532.
10. Silva, D., Petroski, E. and Peres, M. (2012). Prehypertension and hypertension among adults in a metropolitan area in southern brazil: Population-based study. Rev. SaudePublica; 46(3): 988–998.
11. Rahmanian, K., and Shojaie, M. (2012). The prevalence of pre-hypertension and its association to established cardiovascular risk factors in south of Iran. BMC Res. Notes; 5(2): 21-22.
12. Shalom, N., and Opeyemi, C. (2014). Underweight, overweight and obesity amongst young adults in Ota, Nigeria. Academic Journal; 6(7): 235-238.
13. Hana, T. and Ali, A. (2012). Pre-hypertension and hypertension in college students in Kuwait: A neglected issue. JFCM; 19(2): 105.
14. Egan, B.M., Zhao, Y. and Axon, R.N. (2010).US trends in prevalence, awareness, treatment, and control of hypertension; 1988-2008. JAMA; 303:2043.
15. Weil, B., Stauffer, B., Greiner, J. and Desouza, C. (2011). Prehypertension is associated with impaired nitric oxide-mediated endothelium-dependent vasodilation in sedentary adults. Am J hypertens; 24(9): 976.


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