Prevalence of Key Modifiable Cardiovascular Risk Factors among Urban Adolescents: The CRO-PALS Study

Abstract

The occurrence of chronic diseases in youth has become a serious global issue requiring early prevention. Due to the specific environment in large cities, urban youth are especially exposed to risky lifestyle patterns.

Objective: This survey aimed to determine the prevalence of key modifiable cardiovascular risk factors in the adolescent population of the Croatian capital Zagreb.

Methods: A clustered two-stage random sample design was employed to select a representative group of 903 adolescents (girls n = 444; boys n = 459; age 15.6 ± 0.4) starting their secondary education. Participants were invited to fulfil an electronic questionnaire meant to collect data on daily physical activity, screen time and tobacco use. In addition, anthropometric and blood pressure measurements were taken by medically trained personnel. Data that were not originally categorical were dichotomized based on internationally accepted cut-off values for each risk factor, summarized for females and males, and presented as percentages and 95% confidence intervals.

Results: The outcomes suggest that more than one half did not meet the recommended daily physical activity (girls 59.4%; boys 45.5%), a vast majority exceeded 2 h of screen time per day (girls 87.9%; boys 91.6%), and one quarter had high blood pressure (girls 21.6%; boys 27.0%). Moreover, the results indicated nearly one fifth of adolescents had excess weight (girls 16.1%; boys 22.2%) and a similar proportion smoked tobacco (girls 20.8%; boys 17.0%).

Conclusions: Local and regional health stakeholders should make additional efforts to promote healthy lifestyles in urban teenagers. Special emphasis should be placed on promoting physical activity.

Keywords: high school; lifestyle; metropolitan; teenage; unhealthy behavior.

Figure 1

Prevalence of the body mass index (BMI) categories (girls N = 410; boys N = 428), abdominal obesity percentile categories (girls N = 411; boys N = 429), smoking (girls N = 414; boys N = 429), physical inactivity (girls N = 414; boys N = 430), high screen time (girls N = 414; boys N = 429), and raised blood pressure (girls N = 416; boys N = 429) stratified by sex. Error bars represent 95% confidence levels; IOTF = International Obesity Task Force; UW = underweight; OW = overweight; OB = obese. Note: Girls and boys were allocated to the BMI categories according to the IOTF cut-off values proposed by Cole and Lobstein, 2012 [27], and to the abdominal obesity categories based on cut-off values of 90th and 97th centiles for German adolescents of respective age between 2003–2007 (Kromeyer-Hauschild et al., 2010 [28]); physical inactivity refers to <60 min of moderate-to-vigorous physical activity per day; high screen time refers to >120 min of screen related activities per day; Raised blood pressure refers to systolic and/or diastolic blood pressure above the 95th percentile for age, sex, and height as described by Falkner et al., 2001 [31].