Why we’re the world’s most up­tight peo­ple

Sunday Times - - NEWS - CLAIRE KEE­TON

HIGH blood pres­sure in chil­dren is a grow­ing prob­lem in South Africa and af­fects one in four school­child­ren, new re­search has found.

And South Africans older than 50 years have the high­est rate of hy­per­ten­sion in the world, at al­most four in five adults, a re­cent World Health Or­gan­i­sa­tion study found.

The Birth to Twenty (Bt20) study among chil­dren is the first in South Africa to re­port that el­e­vated blood pres­sure con­tin­ues from early child­hood into late ado­les­cence. A third of chil­dren with high blood pres­sure at five and eight years old still had hy­per­ten­sion when they turned 18.

Chil­dren at risk should be screened early to pre­vent high blood pres­sure in adult­hood, Ju­liana Kagura and her coau­thors con­clude.

They an­a­lysed data col­lected from 3 273 pre­dom­i­nantly black chil­dren (78%) in Soweto and Johannesburg from 1990 to 2010 for the Bt20 study, based at the Wits De­vel­op­men­tal Path­ways for Health Re­search Unit.

“We see a lot of hy­per­ten­sion, strokes and heart at­tacks in midlife South Africans. As much as fam­ily history is im­por­tant, the roots may be in child­hood,” Kagura said about the re­sults pub­lished in BMC Pe­di­atrics.

Chil­dren born with a lower birth weight usu­ally have “catch-up growth” and ex­cess weight gain can stress their sys­tem. Be­ing over­weight or obese nearly triples the risk of be­com­ing hy­per­ten­sive.

“As much as we want ba­bies to be chubby, if they are over­weight in the first two years this can be a risk later on,” said Kagura.

South Africa’s shift to re­fined foods and a high salt in­take con­trib­ute to high blood pres­sure and ris­ing obe­sity.

But be­ing over­weight and in­ac­tive are not the only causes and en­vi­ron­men­tal stress is likely to be an ag­gra­vat­ing fac­tor for chil­dren. Kagura spec­u­lated: “Liv­ing in a stress­ful en­vi­ron­ment with crime im­pacts on the psy­cho-so­cial stress of chil­dren who may be afraid to go out­side and play. As they get older they could start smok­ing and drink­ing and this could be linked to an un­safe en­vi­ron­ment.”

More chil­dren in South Africa are over­weight, smoke and use al­co­hol now than be­fore.

Dr Es­sack Mitha, head of the New­town Clin­i­cal Re­search Cen­tre, stud­ied el­e­vated blood pres­sure among 300 ru­ral and ur­ban chil­dren aged seven to 13 years old and found that el­e­vated blood pres­sure was com­mon.

“This has se­ri­ous im­pli­ca­tions for the health of th­ese chil­dren as they ap­proach adult­hood,” said Dr Mitha.

“Fast food and a seden­tary life­style have con­trib­uted to an in­crease in this con­di­tion,” he said, rec­om­mend­ing that schools con­sider ba­sic med­i­cal check­ups for all pupils.

Hy­per­ten­sion was un­com­mon in Africa in the past but this had changed, said Alta Schutte, di­rec­tor of the Med­i­cal Re­search Coun­cil unit for hy­per­ten­sion and car­dio­vas­cu­lar dis­ease.

Prof Schutte, who is also pres­i­dent of the Southern African Hy­per­ten­sion So­ci­ety, said: “World­wide it is well known that high blood pres­sure is more com­mon in black pop­u­la­tions.”

Par­ents who know their fam­ily has a risk for hy­per­ten­sion should get their chil­dren’s blood pres­sure mea­sured from age 10 and on­wards an­nu­ally.

FU­TURE WOES: Chub­bier kids may have a greater risk of high blood pres­sure later in life, re­search shows

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