Hypertension among South African children in disadvantaged areas and associations with physical activity, fitness, and cardiovascular risk markers: A cross-sectional study

J Sports Sci. 2021 Nov;39(21):2454-2467. doi: 10.1080/02640414.2021.1939964. Epub 2021 Aug 1.

Abstract

Childhood hypertension drives hypertension in later life; hence, assessing blood pressure in children is an important measure to determine current and future cardiovascular health. There is, however, a paucity of childhood blood pressure data, particularly for sub-Saharan Africa. This study explores blood pressure and associations with age, sex, socioeconomic status, physical activity, fitness, and cardiovascular risk markers. In the 'Disease, Activity and Schoolchildren's Health' (DASH) study, a cross-sectional analysis was conducted in disadvantaged neighbourhoods in the Eastern Cape province of South Africa. Assessments included blood pressure, accelerometer-measured physical activity, physical fitness, and cardiovascular risk markers. The study consisted of 785 children (383 boys, 402 girls, M = 12.4±0.9 years). Overall, 18% of the children were classified as hypertensive, while 20% were either overweight/obese, and almost four out of ten children did not meet global daily physical activity recommendations. Hypertensive children were more likely to be overweight/obese, χ2 (2,785) = 14.42, p < 0.01, but only if they did not meet physical activity recommendations, χ2 (2,295) = 11.93, p < 0.01. Considering the moderating effect which sufficient activity has on the relationship between hypertension and body weight, more emphasis should be placed on early primary health intervention and education strategies.

Keywords: Cardiovascular risk markers; South Africa; hypertension; physical activity; physical fitness; schoolchildren.

MeSH terms

  • Age Factors
  • Body Composition
  • Cardiorespiratory Fitness / physiology
  • Child
  • Comorbidity
  • Cross-Sectional Studies
  • Exercise / physiology*
  • Female
  • Hand Strength / physiology
  • Heart Disease Risk Factors*
  • Humans
  • Hypertension / epidemiology*
  • Male
  • Overweight / epidemiology
  • Pediatric Obesity / epidemiology
  • Physical Fitness / physiology*
  • Poverty*
  • Prehypertension / epidemiology
  • Prevalence
  • Sex Factors
  • Social Class
  • South Africa / epidemiology