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Year : 2016  |  Volume : 143  |  Issue : 1  |  Page : 114-115

Paediatric hypertension in Iraq

Department of Paediatrics, Al-Kindy College of Medicine, Baghdad University, Baghdad, Iraq

Date of Web Publication14-Mar-2016

Correspondence Address:
Mahmood Dhahir Al-Mendalawi
Department of Paediatrics, Al-Kindy College of Medicine, Baghdad University, Baghdad
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0971-5916.178622

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How to cite this article:
Al-Mendalawi MD. Paediatric hypertension in Iraq . Indian J Med Res 2016;143:114-5

How to cite this URL:
Al-Mendalawi MD. Paediatric hypertension in Iraq . Indian J Med Res [serial online] 2016 [cited 2020 Oct 29];143:114-5. Available from:


The interesting study by Borah et al[1] has inspired me to throw light on paediatric hypertension (HT) in Iraq and compare it with that reported in India.

First, Borah et al[1] did well in addressing four study limitations. I presume that there is another important methodological limitation. Borah et al[1] mentioned that the overweight and obesity were assessed by body mass index (BMI) percentiles for age based on Centers for Disease Control (CDC) 2000 dataset for both genders. It is noteworthy that obesity prevalence in a given population can be determined using four different diagnostic criteria namely, International Obesity Task Force reference, CDC2000 dataset, World Health Organization reference 2007, and national reference [2] . Applying different BMI references could result in marked differences in obesity prevalence. To my knowledge, no Indian sex- specific BMI-for-age references are yet constructed to be employed. On the other hand, I presume that the studied Indian population is polygenetic. This is important to be considered as significant differences in BMI among different ethnic groups exist [2] . If so, this methodological limitation might cast suspicions on the reported HT prevalence, blood pressure (BP) distribution, and HT correlates in this study [1] .

Second, HT prevalence and the pattern of distribution of systolic BP (SBP) and diastolic BP (DBP) in both genders are quite different [1] compared to that reported in Iraq [3] . Borah et al reported that girl children had significantly higher mean SBP (104.2 ± 12.0 vs. 103.2 ± 11.6 mmHg, P<0.001) than boys. With increase of age, there was a gradual rise in both SBP and DBP in boys and girls [1] . In Iraq, there were no significant differences noted with respect to SBP and DBP among boys and girls except at the age range of 10-12 yr, where girls manifested higher SBP (P<0.01) and DBP (P<0.05) than boys [3] . The reported HT prevalence (7.6%) in Borah et al study [1] is higher than 1.7 per cent reported in Iraq [3] . This difference might be attributed to the variations in study design, definition of HT, methods of BP recording, observer effect, age range, sample size, ethnicity, and socio-economic class [4] as well as the preponderance of obesity among Iraqi children (7.3%) [3] compared to the low obesity prevalence reported by Borah et al (2.9%) [1] .

Third, I agree with Borah et al[1] that strengthening of school health programme is fundamental to prevent future epidemic and complications of HT. Actually, implementing a school-based intervention to teach children on the healthy heart has shown improvement in their knowledge, increasing their awareness on healthy lifestyles, and has the potential to reduce the risk of atherosclerosis in both the individual child and the population at large [5] . In Iraq, a school-based heart health curriculum has been launched and the results of evaluating its impact on awareness and HT prevalence are to be shortly addressed.

   References Top

Borah PK, Devi U, Biswas D, Kalita HC, Sharma M, Mahanta J. Distribution of blood pressure & correlates of hypertension in school children aged 5-14 years from North East India. Indian J Med Res 2015; 142 : 293-300.  Back to cited text no. 1
Al-Mendalawi MD. Assessment of obesity in school children. J Med Nutr Nutraceut 2014; 3 : 230.  Back to cited text no. 2
Subhi MD.Blood pressure profiles and hypertension in Iraqi primary school children. Saudi Med J 2006; 27 : 482-6.  Back to cited text no. 3
van de Mheen PJ, Bonneux L, Gunning-Schepers LJ. Variationin reported prevalence of hypertension in the Netherlands: the impact of methodological variables. J Epidemiol Community Health 1995; 49 : 277-80.  Back to cited text no. 4
Nabipour I, Imami SR, Mohammadi MM, Heidari G, Bahramian F, Azizi F, et al. A school-based intervention to teach 3-4 grades children about healthy heart; the Persian Gulf healthy heart project. Indian J Med Sci 2004; 58 : 289-96.  Back to cited text no. 5


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