Abstract

STUDY OBJECTIVE: To assess which factors are associated with total cholesterol concentration and blood pressure in 9 year olds, and to examine the extent to which a report of a heart attack in a close relative identifies children with a high total cholesterol value or high systolic blood pressure. DESIGN: This was a cross sectional study. SETTING: The analysis was based on 22 study areas from a representative English sample, 14 areas from a representative Scottish sample, and 20 areas from an inner city sample. PARTICIPANTS: There were 1987 children aged 8 or 9 whose blood pressure was measured and 1662 children whose total cholesterol was assessed. MEASUREMENTS AND MAIN RESULTS: Blood pressure was measured using the Dinamap 1846 automated sphygmomanometer and cholesterol using the Lipotrend C. Multiple regression analysis was used to examine the independent associations with each of the outcome variables. Either weight for height or sum of skinfolds measured in four sites was highly associated with the outcome measures in the study (p < 0.001). Fatter or overweight children had higher blood pressure and higher cholesterol concentrations. Child's height was also associated with the outcome measures in most of the analyses, but was positively related to blood pressure and negatively associated with cholesterol value. There was an association between diastolic blood pressure and area of residence as represented by the regional health authority (RHA), but the association was not the same as the association reported between coronary heart disease, standardised mortality ratio, and RHA. Children with low birth weight and those with shorter gestation had higher systolic blood pressure (p < 0.05 and p < 0.01 respectively), but not diastolic blood pressure. A report of a premature heart attack in a parent or a grandparent was not associated with higher cholesterol or blood pressure. CONCLUSIONS: Reducing obesity in children, together with the avoidance of smoking, may be an appropriate action to prevent coronary heart disease in adulthood. A report of heart disease in a close relative is an ineffective means of identifying children at greater risk of high cholesterol or blood pressure without other measurements from relatives.