Elevated Blood Pressure and Associations with Sodium Intake Among Multiethnic Youth in Edmonton, Canada: Findings from W
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ORIGINAL ARTICLE
Elevated Blood Pressure and Associations with Sodium Intake Among Multiethnic Youth in Edmonton, Canada: Findings from WHY ACT NOW Fariba Kolahdooz1 · Forouz Nader1 · Se Lim Jang1 · Maryam Daemi1 · Justin A. Ezekowitz2 · Nora Johnston3 · Kennedy Cruickshank4 · Sangita Sharma1 Received: 25 November 2019 / Accepted: 25 March 2020 © Italian Society of Hypertension 2020
Abstract Introduction This study examined the prevalence of pre-hypertension (PHT) and hypertension (HT) in urban youth, and assessed the effects of sodium intake and obesity on blood pressure (BP) by ethnicity. Methods A convenience sample of 557 multiethnic youth, aged 11–23 years, was recruited from 12 schools and institutions in Edmonton, Alberta, Canada. Participants were divided by self-identified ethnicity into four groups (Indigenous, African and Middle Eastern (AME), Asian, and European). Results Between October 2013 and March 2014, one-on-one interviews were conducted to collect data on demographics, physical activity, diet, and Body Mass Index (BMI). BP was obtained at two different times during the interview and measured a third time in cases of high variability. The standard deviation scores (SDS) of systolic BP (SBP) and diastolic BP (DBP) were used to estimate associations with sodium intake (per 1000 mg/day). Overall, 18.2% and 5.4% of the participants had PHT and HT, respectively. Indigenous and AME participants showed the highest rates of PHT (23.1%). Indigenous and European participants showed higher rates of HT (8.3% and 5.3%, respectively) than other ethnic groups (AME = 4.4%, Asian = 3.9%). There was a positive association between 1000 mg/day increase in sodium intake and SDS of SBP by 0.041 (95% CI 0.007–0.083; p = 0.04) among pre-hypertensive participants. Over 85% of participants exceeded the recommended dietary sodium intake. Mean BMI and dietary sodium intake were higher among pre-hypertensive participants (4219 mg/ day) than normotensive (3475 mg/day). Conclusions The prevalence of HT varied by ethnicity. High dietary sodium intake was of concern. There is a need for culturally-tailored, population-based interventions to reduce sodium intake. Keywords Hypertension · Lifestyle · Youth · Urban · Edmonton · Multiethnic
1 Introduction * Sangita Sharma [email protected] 1
Indigenous and Global Health Research Group, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Unit 5‑10 University Terrace, 8303‑112 Street, Edmonton, AB T6G 2T4, Canada
2
Canadian VIGOUR Centre, Department of Medicine, Faculty of Medicine and Denistry, University of Alberta, Edmonton, AB, Canada
3
Alberta Centre for Active Living, Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
4
Department of Nutritional Sciences, King’s College London, London, England
Hypertension (HT) is a key risk factor for cardiovascular diseases, causing over half of all strokes and ischaemic heart disease deaths globally [1]. In 2008, the worldwide prevalence of
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