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An analysis of sex differences and socioeconomic deprivation among Canadian children with high blood pressure: a retrospective, cross-sectional study

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Abstract

Background

Understanding which children are at highest risk for high blood pressure (HBP) can inform surveillance and treatment. This study evaluated sex differences in childhood HBP and its associations with socioeconomic status.

Methods

This retrospective cross-sectional study assessed 74,233 children with data from a national primary care electronic medical record database. Differences between sex and material and social deprivation scores for children with and without HBP were examined. Covariates included age, BMI z-score, diabetes, hyperlipidemia, and depression. HBP was defined as > 90th percentile for < 13-year-olds, and ≥ 120/80 for age ≥ 13 years on 2 separate occasions between 2010 and 2017.

Results

The prevalence of HBP was 10.2% in males and 7.6% in females (p < 0.0001). Children with HBP had higher BMI z-scores (0.66 vs. 0.18, p < 0.0001), and higher rates of diabetes (1.31 vs. 0.54%, p < 0.0001), depression (9.89 vs. 7.11%, p < 0.0001), and hyperlipidemia (2.82 vs. 0.86%, p < 0.0001). In univariate regression analyses, boys in the most materially deprived quintile had increased odds of HBP (OR 1.24 (95% CI 1.08–1.43)), whereas females did not (OR 1.11 (95% CI 0.95–1.29)). In multivariate regression, male sex was associated with HBP with adjusted OR of 1.39 (95% CI 1.24–1.55). After statistical adjustment, material deprivation was no longer significant (aOR 1.05, 95% CI 0.94–1.17).

Conclusions

Male sex is associated with HBP in Canadian children. This study also suggests a possible association between material deprivation and HBP, particularly in boys. Further study is required to better understand this relationship.

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Abbreviations

BP:

Blood pressure

HBP:

High blood pressure

CVD:

Cardiovascular disease

SES:

Socioeconomic status

CPCSSN:

Canadian Primary Care Sentinel Surveillance Network

EMR:

Electronic medical record

BMI:

Body mass index

DA:

Dissemination area

ABSM:

Area-based socioeconomic measure

WCH:

White-coat hypertension

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Funding

This work was funded by the Children’s Hospital Research Institute of Manitoba (CHRIM) as a catalyst grant from the Diabetes Research Institute of Manitoba (DREAM) Research Theme.

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Authors and Affiliations

  1. Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada

    Susan Telencoe

  2. Department of Family Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada

    Alexander Singer & Leanne Kosowan

  3. Department of Pediatrics and Child Health, Diabetes Research Envisioned and Accomplished, University of Manitoba, Children’s Hospital Research Institute of Manitoba, FE-009 840 Sherbrook St, Winnipeg, MB, R3A 1R9, Canada

    Allison B. Dart

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  1. Susan Telencoe
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  2. Alexander Singer
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Contributions

S. Telencoe conceptualized and designed the study, preformed initial data analysis, created the first draft and revised the final copy of the manuscript. L. Kosowan conducted the statistical analysis and provided revisions for the final manuscript. A. Singer provided consultative support for the database and provided revisions for the final manuscript. A. Dart conceptualized and designed the study, supervised, and revised the entirety of the study. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

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Correspondence to Allison B. Dart.

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Telencoe, S., Singer, A., Kosowan, L. et al. An analysis of sex differences and socioeconomic deprivation among Canadian children with high blood pressure: a retrospective, cross-sectional study. Pediatr Nephrol 38, 2137–2145 (2023). https://doi.org/10.1007/s00467-022-05841-6

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