Blood pressure screening of school children in a multiracial school district: the Healthy Kids Project.

Background: There are few studies of the prevalence of elevated blood pressure (BP) that include American Indian school children. Therefore, the intent of this study was to examine the relationships between BP and risk factors in a multiracial, predominantly American Indian, school district.

Methods: A total of 1,829 American Indian, white, Hispanic, and African American students, 5-17 years old, were included in this study. The mean of two BP measurements, taken at the initial screening with an electronic BP monitor, were categorized as normal, prehypertensive, or hypertensive using the 2004 Fourth Report BP screening recommendations. Prevalence of prehypertensive and hypertensive BP measurements by race, gender, age, and body mass index (BMI) were determined, and their associations analyzed with logistic regression.

Results: The prevalence of prehypertensive measurements was 16.7% and prevalence of hypertensive measurements was 13.8% at first screen. Obesity was a risk factor for elevated BP for females and males (adjusted odds ratio (OR) = 4.01 and 4.33, respectively). Older age was also significantly associated with prehypertensive and hypertensive BP measurements, especially among males (adjusted OR = 6.91). Among females, American Indian race was protective against elevated BP (adjusted OR = 0.61).

Conclusions: Obesity was consistently associated with an increased risk for elevated BP. American Indian race was associated with decreased risk of elevated BP measurements in females. The high prevalence of obesity-related hypertensive measurements in this population that includes American Indian children was similar to levels found in other multiracial populations of school children when using BP measurements from a single assessment.