Effect of Comprehensive Interventions Including Nutrition Education and Physical Activity on High Blood Pressure among Children: Evidence from School-Based Cluster Randomized Control Trial in China

Abstract

Childhood hypertension has increasingly become a public health problem globally. However, limited literature research examined the effect of comprehensive interventions including nutrition education and physical activity on blood pressure among children. A total of 6764 children aged 7-13 years were analyzed based on a multicenter randomized controlled trial for comprehensive interventions in 30 primary schools in China to evaluate the effects on blood pressure, which lasted for two semesters. The standards used for the diagnosis of high blood pressure were the cut-off points based on age and sex for Chinese children. Compared with the control group, the intervention effects were -0.5 mm Hg (95% confidence interval (CI): -1.1, 0; p = 0.064) for diastolic blood pressure and -0.9 mmHg (95% CI: -1.5, -0.3; p = 0.005) for systolic blood pressure. For the incidence of high blood pressure, the changes were -1.4% in the intervention group and 0.4% in the control group (1.8% difference between the two groups, p = 0.015) after trial. The school-based comprehensive interventions appeared to have moderate effects on high blood pressure prevention among children in China.

Keywords: blood pressure; children; comprehensive intervention; high blood pressure; hypertension; nutrition education; obesity; physical activity.

Figure 1

The CONSORT flowchart of the study.

Figure 2

The scatterplots for BMI changes and BP changes in intervention and control groups: (a) BMI and DBP in intervention group, (b) BMI and SBP in intervention group, (c) BMI and DBP in control group, (d) BMI and SBP in control group.