{"content":[{"text":"2","bbox":{"left":0.06429,"top":0.046551,"width":0.008063,"height":0.016023000000000003}},{"text":"J Blood Pressure Hypertens","bbox":{"left":0.750538,"top":0.046551,"width":0.18389500000000003,"height":0.016023000000000003}},{"text":"Methodology \n Study design, population and period \n This is a cross-sectional study carried out in a population made up of adolescents aged 15 to 19, regularly enrolled in targeted schools in \n Lubumbashi (capital of the Haut-Katanga Province and second largest city in the Democratic Republic of Congo) whose parent or guardian \n has freely read and signed the informed consent during the following school years: 2013 – 2014, 2014 – 2015, and 2015 – 2016. \n Our sample consisted of 1,766 adolescents who were randomly recruited according to a two-level cluster stratified sampling plan. \n Thus, a sample of schools (distributed by municipality) were successively selected, then a sample of classes in each selected school, \n and finally all the students (statistical units) enrolled within the selected classes were retained as adhering to the investigation. The \n data were collected by the trained medical study team who received refresher training at the start of each data collection phase. \n We included in this study: \n • Any subject aged 15 to 19 and regularly enrolled in a primary or secondary school in the city of Lubumbashi; \n • Have a birth weight declared by one of the parents or the legal guardian of the pupil who has consented to undergo the examination \n without constraint; \n • Parent / guardian having signed the free and informed written consent, according to the Declaration of Helsinki and its \n amendments before participating in the study. \n We have excluded: \n • Any subject who does not meet the conditions of schooling or age; \n • Any student or parent who has expressed a refusal to take the exam; \n • Any subject carrying a chronic disease which influences blood pressure (nephropathy, diabetes mellitus, personal history of \n hypertension); \n • Any subject taking a drug treatment which can influence blood pressure including anti-hypertensives, anti-arrhythmics, \n psychostimulants, corticosteroid therapy, and thyroidhormones. \n Study variables \n The variables in our study were: age, sex, systolic blood pressure (SBP), diastolic blood pressure (DBP), weight, height, body mass \n index (BMI), waist circumference (WC), frequency heart rate (HR) and birth weight. \n BP and heart rate (HR) were measured using a Datascope Accutorr Plus brand automatic oscillometric blood pressure monitor \n (Datascope Corporation, USA). SBP and DBP measurements were calculated as the average of the last two of the three measurements, \n and were considered for analysis. This device gave at the same time the BP and the HR. Appropriately sized, Critikon brand cuffs \n (GE Healthcare, USA) were also used, depending on the width of the arm (at least 40% of the arm circumference) and its length (12 \n x 19 cm, 17 x 25cm, 23 x 33cm, to cover 80-100% of the subject's arm circumference). The cuff size was determined by measuring \n the circumference at mid-height of the arm. BP and HR were measured at least 30 minutes after physical exercise or the last meal, \n in a subject at rest 5 minutes before taking [1,8,11]. Subject was in a seated position with arm and back supported, cuff at heart \n level, feet resting on the floor, and legs uncrossed. The cuff was applied to the right arm, then wrapped to a seal that did not allow \n two fingers to be inserted under it. The lower edge of the cuff was placed 2 cm from the ulnar dimple. Each student was given three \n BP and HR measurements, one minute apart, on the same day [12]. The weight (expressed in kg recorded to the nearest 0.1 kg) \n was measured twice, in a lightly dressed subject, barefooted, standing on a digital medical scale of the SECA brand (SECA 881 U, \n Germany). The height (recorded to the nearest 0.1 centimeter) was measured twice with a vertical measuring board, in a barefoot \n subject, standing, with the shoulders and hips perpendicular to the central axis, the heels against the step, knees together, arms \n relaxed at your sides and head straight (head looking forward so that the lower edge of the eye sockets is in the same horizontal \n plane as the external auditory canal). Waist circumference, according to the protocol of the American Academy of Pediatrics [2] \n and the European Childhood Obesity Group [8], was measured twice, using a non-stretch measuring tape, directly on the skin, at \n the level of the iliac ridges, at the moment of expiration, in a standing subject, relaxed, not tucking his belly. \n BMI was calculated from the formula: BMI = weight (in kilograms) divided by height (in meters) squared and expressed in kg / m². \n In developing countries such as ours, given the insufficient declaration of births in the civil registry, we have resorted to birth \n weights declared by parents or guardians, a strategy adopted by UNICEF and WHO in 2004 for estimating low birth weight in \n developing countries [13]. \n Definition of elvated blood pressure \n Taking into account the recommendations of the fourth report of the National High Blood Pressure Education Program Working \n Group on High Blood Pressure in Children and Adolescents [2,8]. Thus, in our series, the definition of EBP is based on the \n recommendations of the 2017-Guideline for the Prevention, Detection, Evaluation, and management of higth Blood Pressure in \n Adults, i.e. SBP values ranging from 120 to 129 mmHg and those of DBP less than 80 mmHg (120-129/<80 mmHg) [14].","bbox":{"left":0.067966,"top":0.074159,"width":0.8644000000000001,"height":0.849989}},{"text":"ScholArena | www.scholarena.com","bbox":{"left":0.064289,"top":0.935521,"width":0.232512,"height":0.01602300000000001}},{"text":"Volume 1 | Issue 1","bbox":{"left":0.815337,"top":0.935183,"width":0.12180700000000011,"height":0.01602300000000001}}],"images_bbox":[],"images_bbox_not_text_overlap":[]}