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Characterization of the Blood Presure Values in Children from 5 to 14 years old living in Guantanamo, Cuba

Elías Sierra, Reinaldo; Betancourt Pulsan, Anselma; Armas López, Marisel; Pérez de la Iglesia, Sulay

General Teaching Hospital " Dr. Agostinho Neto"
Guantanamo, Cuba



Introduction: prevalence of systemic blood hypertension (BP) differs according to the regions of the world. Criteria for diagnosis in children have not been internationally established, a fact that restricts measuring the problem. The importance of this study is revealed, since in Cuba figures extrapolated from other countries are used, although influence by geographic factors has been confirmed, so that each country is required to establish its patterns in their own population, due to the problem of comparing people genetically different.
Objectives: Establish patterns of systemic blood pressure (percentiles 90 and 95) according to age and sex, and reflects the influence in these by family history in first degree of blood hypertension (FHFD-BP).
Method: We studied 200 children from Guantanamo (100 male and 100 female) in each year of age, from 5 to 14 (n=2000), selected at random according to age, sex, nutritional state. Systolic and diastolic systemic blood hypertension is registered by the Korotkoff method, and international recommendations. Results are validated by the analysis of variance, and the student test.
Results: In males and children with FHFD-BP the figures of systemic blood pressure are higher (p<0.01) regardless of age, sex, and nutritional state. Percentiles 90 and 95 are established for systolic and diastolic systemic blood pressure for this population.



The Systematic Arterial Hypertension is one of the main cardiovascular risk factors and it represents a health problem in our contemporary world. To modify its epidemiologic behavior in Cuba is a priority of the Ministry of Public Health.
Hypertension affects children; however, no internationally conclusive criteria have been established for its diagnosis in infants, Cuba has been using those criteria brought from others countries, despite the fact that it has been proveen that they are modified by the influence of geographic factors which demand that each country makes an effort to establish its own patterns due to the inconvenience of comparing genetically different populations whose life-style are developed in different environmental conditions .



To specify the values of systematic blood pressure in a sample of Cuban children from 5 to 14 years old living in Guantanamo Municipality in 1998, their patterns and the percentiles 90 and 95 according to age and sex, and to notice the influence of first degree family antecedent in them.



A descriptive and applied study was carried out in Guantanamo Municipality, Cuba in 1998. Three hundred children were studied per each age group from 5 to 14 years old (150 girls and 150 boys in each year) for a total of 3000 unit of analysis. They were selected at random matched by age, sex and skin color.
They had to fullfill the following criteria: have Cuban parents, be authorized by their parents to undergo the research, not to have suffered from any desease or taken any kind of medications or chemical substances that affect the BP values for at least 5 lives average. Eutrophic nutritional state.
The BP valves were registered according to the international standars (norms) and following Korotkoff ausculatory method. After the evaluation of every 100 units of analysis was completed the monitoring quality was controlled. Each child was measured twice by the same evaluator with intervals of 30 minutes.
To satisfy the objectives of the research in each subject the age, sex, first degree family antecedent of BP ( mother, father, brothers and sisters), so as the systolic pressure and diastolic pressure were defined. The average values and the standard deviations were established so as the percentile 90 and 95 for systolic and diastolic pressures for each subgroup according to age and sex. The differences between groups were validated according to the analysis of variance or the test for the different averages for a level of significancy of p£ 0.05.



The tables reflect the average values standard deviations and percentiles 90 and 95 for systolic pressure and diastolic pressure for each subgroup of age and sex, so as the influence of the family antecedent of BP in the values of systolic pressure and diastolic pressure.


Table 1
Characterization of the values of blood pressure ( mm Hg) according to age and sex

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Legend: X: Average SD: Standart Deviation


Table 2
Percentile 90 and 95 for blood pressure in children according to age

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Legend: F: Female M: Male P: Percentiles


Table 3
Variation of blood pressure values ( mm Hg) in the children studies according to family antecedent of hypertension

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Legend: X: Average  SD: Standart Deviation



The Panamerican Health Organization has proclaimed the need to establish the BP values in children and adolescents for their application in Latin America and the Caribbean taking into account the regional differences. In the research, the increase of BP according to the age and its higher values for boys and children with family antecedent of systematic Arterial Hypertension were proven.
These resukts were similar to those of others authors who affirm the BP increase according to weight and height or index of corporial mass.
In general the systolic and diastolic values (percentiles 90 and 95) established in the research are inferior to those nominated by the "Task Force on Blood Pressure Control in Children" may be due to regional differences . The BP higher values in boys could be related to a higher neurovegetative vulnerability and vascular reactivity in them. The family antecedent of hypertension has been checked in hypertensive children in all age groups and it is stated that the first degree descendants of hypertensive patiens are in more risk of suffering from hypertension in the future.



The systolic and diastolic pressures so as the respective percentiles 90 and 95 for a Cuban infant population in Guantanamo (5 to 14 years old) are established, reflecting significant differences in such respect according to sex (higher in boys) and family antecedent of hypertension.


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