DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20171718

Study on variation of blood-pressure in relation to posture among children aged 4-14 years

Rajparath Ragu, Rangesh Siddhuraj, Jeganatha Athiveera Rama Pandian Kasimani, Senthamarai Murugaiyan vadivelu, Rajasekaran Seethapathy, Shankar Radhakrishnan

Abstract


Background: The response of blood pressure to change in body position has been used in epidemiological studies as a measure of cardiovascular reactivity. Studies had shown that the difference between the supine and seated blood pressures is positively associated with subsequent development of systemic hypertension independent of supine blood pressure. Objective of present study is to study the variation in blood pressure among children in the age group of 4-14 years in relation to the change in their posture.

Methods:  cross-sectional study was conducted in a rural area near our medical college hospital. A primary and middle school in that area was selected for our study. A total of 500 children in the age group of 4 -14 years were included in our study. Demographic profile was recorded for all children. Height, weight and BMI were measured. Blood pressure measurement was done by using the auscultation method and with appropriate sized blood pressure cuff.

Results: The blood pressure shows a gradual increase as the age of the study subjects increases and there was no statistically significant difference in the blood pressure between males and females (p>0.05). Supine posture shows a comparatively higher systolic pressure and a lower diastolic pressure reading than the sitting and standing posture. The mean difference in systolic blood pressure between sitting and supine posture was less than the mean difference between sitting and standing and the mean difference between supine and standing, which was found to be very high and a similar type of result was also shown in the diastolic blood pressure and this mean difference between the postures was found to be statistically significant (p<0.05).

Conclusions: Postural changes in systolic and diastolic deserve further study as a potential risk factor for the development of hypertension as this could be easily measured in clinical practice and in epidemiological studies.

 


Keywords


Blood pressure, Posture, Rural area, Supine, Sitting and standing

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References


Nardo CJ, Chambless LE, Light KC, Wayne D. Descriptive epidemiology of blood pressure response to change in body position. The ARIC Study. Hypertens. 1999;33:1123-9.

Sagie A, Larson MG, Levy D. The natural history of borderline isolated systolic hypertension. N Engl J Med. 1993;329:1912-7.

Franklin SS, Jacobs MJ, Wong ND, L’Italien GJ, Lapuerta P. Predominance of isolated systolic hypertension amongmiddle-aged and elderly US hypertensives: analysis based on National Health and Nutrition Examination Survey (NHANES) III. Hypertens. 2001;37:869-74.

Hayman LL, Meininger JC, Daniels SR, McCrindle BW, Helden L, Ross J et al. Primary prevention of cardiovascular disease in nursing practice: focus on children and youth: a scientific statement from the American Heart Association Committee on atherosclerosis, hypertension, and obesity in Youth of the council on cardiovascular disease in the young, council on cardiovascular nursing, council on epidemiology and prevention, and council on nutrition, physical activity, and metabolism. Circulation. 2007;116:344-57.

Janz KF, Dawson JD, Mahoney LT. Predicting heart growth during puberty: The Muscatine Study. Pediatr. 2000;105:E63.

Freeman R, Wieling W, Awelrod FB, Benditt DG, Benarroch E, Biaggioni I et al. Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Clin Auton Res. 2011;21:69-72.

Singer W, Sletten DM, Opfer-Gehrking TL, Brands CK, Fischer PR, Low PA. Postural tachycardia in children and adolescents: what is abnormal? J Pediatr. 2012;160:222-6.

Gauer OH, Thron HL. Postural changes in circulation. In: Dow,P ed. Handbook of Physiology, Section 2, Hamilton WF. Washington DC:American Physiology Society;1965:2409-39.

Tell GS, Prineas RJ, Gomez-Marin O. Postural changes in blood pressure and pulse rate among black adolescents and white adolescents: the Minneapolis Children's Blood pressure study. Am J Epidemiol. 1988;128(2):360-9.

Gotshall RW, Tsai PF, Bassett Frey MA. Gender-based differences to the cardiovascular response to standing. Aviat Space Environ Med. 1991;62:855-9.

Schondorf R, Low PA. Gender related differences in the cardiovascular responses to upright tilt in normal subjects. Clin Auton Res. 1992;2:183-7.

MacLennan WJ, Hall MRP, Timothy JI. Postural hypotension in old age: is it a disorder of the nervous system or of blood vessels? Age Ageing. 1980;9:25-31.

Moore KI, Newton K. Orthostatic heart rates and blood pressures in healthy young women and men. Heart Lung. 1986;15:611-7.

Borst C, van Brederode JFM, Wieling W, van Montfrans GA, Dunning AJ. Mechanisms of initial blood pressure response to postural change. Clin Sci. 1984;67:321-7.

Goldstein IB, Shapiro D. Cardiovascular response during postural change in the elderly. J Gerontol. 1990;45:M20-M25.

Chan HL, Lin MA, Chao PK, Lin CH. Correlates of the shift in heart rate variability with postures and walking by time frequency analysis. Compute Methods Programs Biomed. 2007;86:124-30.

Grethe S Tell, Ronald J Preneas and Orlando Gomez Marine.postural changes in blood pressure and pulse rate among black adolescents and white adolescents. The Minneapolis Children blood pressure study. Am J Epidemiol. 1987;128(2):360-5.

Honda K, Nose T, Yoshida N. Response to the postural change and orthostatic dysregulation symptoms: a population study on Japanese junior and senior high school students. Jpn Circ J. 1977;41:629-41

Katz SH, Semel B, Hediger ML. Resting supine and seated bold pressure interrelations in adolescents. In:Gruskin AB, Norman ME, eds. Pediatric Nephrology. The Hague, The Netherlands; Martinus Nijhoff Publishers;1981:517-26.

Jorde LB, Williams RR. Innovative blood pressure measurements yield information not reflected by sitting measurements. Hypertension. 1986;8:252-7.

Moore KI, Newton K. Orthostatic heart rates and blood pressures in healthy young women and men. Heart Lung. 1986;15:611-7.

MacLennan WJ, Hall MRP, Timothy JI. Postural hypotension in old age: is it a disorder of the nervous system or of blood vessels? Age Ageing. 1980;9:25-31.

Gotshall RW, Tsai PF, Bassett Frey MA. Gender-based differences to the cardiovascular response to standing. Aviat Space Environ Med. 1991;62:855-9.

Schondorf R, Low PA. Gender related differences in the cardiovascular responses to upright tilt in normal subjects. Clin Auton Res. 1992;2:183-7.