الفهرس 
AcknowledgementOnly 14 pages are availabe for public view
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Abstract
Measuring of blood pressure during childhood is of particular interest because it may be possible to identify those with early essential hypertension or those at high risk for development of sustained essential hypertens ion later in 1 i fe. High blood pressure or hypertension is considered a major cause of death and morbidity in many populations. It is reasonable to assume that the detection and control of elevated blood pressure during the pre-adul t years could alter of the disease in adult years and reduce the complications of stroke and myocardial infarction. The aim of the present study is to illustrate the ,1 eve 1 s of blood pressure among primary school chi Idren in Alexandria and its relation to some biological and socioeconomic study is an attempt to put a local percenti le distribution of blood pressure of chi ldren aged 7-13 years in Alexandria primary schoo 1 s, to be a guide line for detecting children with an elevated blood. pressure. To accompl ish such an aim, a cross-sectional study was conducted. The sample size was determined using the proportional allocation method, which was 0.25 of the total number of primary school children in the six areas of Alexandria in the school year 1988-1989, thus reaching 605 students. One primary governmental school was selected from each area. From each school 5 classrooms were selected one from each grade exc I uding the first grade (since children in this level were not cooperative). . A sample of 100 pupi I s (20 from each grade) from a language school was selected purposively in order to represent the students of high economic level of nongovernmental high paying schools. Thus’ the total sample reached 705 students. The techniques used were cl inical examination, blood pressure measurement, urine analysis, interviewing questionnaire and anthropometric measurement. Clinical screening included heart and chest examination to exclude any pathological conditions which might affect the blood pressure secondarily. Blood pressure measurement was done for the non excluded l1li chi 1 dren. Urine analysis was done for those chi ldren whose blood pressure was above 140/90mmHg to exclude secondary hypertension due to kidney disease. Interviewing questionnaire was done for non excluded children and it included: 1) Personal data about age, sex and birth order. 2) Socioeconomic data such as work and education of the parents, crowding index,percapita income and home sanitation. 3) 4) Personal and family history of health problems. Salty food eating habits. 5) . Anthropometric measurements , ¥ i , , Physical exercise which included questions about the practice of exercise and the number of training sessions per week. . such as weight, height and triceps skin fold thickness were measured for all children included in the sample. Weight for height was calculated and compared with Harvard’s standards. Analysis of data collected was done by the staff of the Biostatistics department of the H. I .P.H, University of Alexandria. The results of the study could be summarized as follows: The percentile distribution of boys and girls’systolic and diastolic blood pressures showed gradual increase (in both systolic and diastolic pressure)with age. The mean systol ic and diastol ic blood pressures of boys were higher than girls only among students of the age group 7-(9 years, while the mean systolic and diastolic blood pressures of girls were higher than that of boys in the age groups 9-<11,11-13 years. However the difference was statistically insignificant. A posi ti ve correlation was found between mean blood pressure levels, weight for height and skin fold thickness. The correlation was statistically significant. The mean systolic and diastolic blood pressures of students was sI ightly higher among chi ldren of high social class than children of very low social class. However the difference was statistically insignificant. .The mean systol ic and diastol ic blood pressures of students with negative family history of hypertension was always lower than that of students with positive family history of any degree of familial . relations. The difference was statistically significant. The mean systolic and diastolic blood pressures of students with .low crowding index that is,<2 jroom,was always higher than that of students with high crowding index that is,S or more jroom. However the difference was statistically insignificant. The mean systolic and diastolic blood pressures of students ranking the first was always slightly higher than that of students ranking the fourth or more in the 3 age groups. However the difference was statistically insignificant. The highest values of mean systolic and diastolic blood pressures were among students scored as very highly and highly consuming salty food and lowest values were among students consuming low amounts of salty food. The difference was statistically significant. The mean systolic and diastolic blood pressures of students who did not practice any physical exercise was higher than that of students who played exercise whether for competition or for recreation. The difference was statistically significant. The following are the main recommendations suggested by the study: 1 Blood pressure levels in children should be measured as a part of the routine comprehensive medical examination done in schools. ~ . The child’s blood pressure should be recorded and plotted on the percentile charts in order to determine whether the child is trending in a favorable direction or not. ~ Children at risk should be educated and encouraged to reduce excessive salt intake and obesity. 4 Physical exercise educational programs should be encouraged in schools/clubs and youth centers. 5 Further studi es are needed in order to i 11 ustrate the patterns of blood pressure distribution among other age groups and to confirm the effect of various factors studied in the present work on blood pressure levels of children.^leng