Coronary heart disease risk factors in Newfoundland children

Balram, B. Christofer M. (1982) Coronary heart disease risk factors in Newfoundland children. Doctoral (PhD) thesis, Memorial University of Newfoundland.

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Abstract

A cross-sectional epidemiological study was carried out to investigate the distribution of coronary heart disease (CHD) risk factors in children aged 8-10 and 14-16 years living in two regions of Newfoundland characterised by high and low CHD mortality rates among adults. The age-adjusted CHD mortality rates for males and females in the high mortality region (HMR) were 298 and 131 per 100,000 respectively, compared to 198 and 85 per 100,000 population for males and females respectively in the low mortality region (LMR). Participants attended schools, randomly chosen from two communities in each region. -- Height, weight, systolic and diastolic blood pressures were measured in Phase I. Also, an EKG was recorded and a questionnaire administered. -- In the HMR, 275 (87%) children aged 8-10 and 383 (89%) aged 14-16 years responded positively. In the LMR, 255 (94%) children aged 8-10 and 259 (89%) children aged 14-16 years participated. -- Ten-hour fasting blood samples were taken in Phase II. Participants in the first phase were eligible to give blood. Sera were analysed for total and HDL cholesterol, triglyceride, uric acid and glucose. In the HMR, 242 (88%) children aged 8-10 and 350 (91%) aged 14-16 years participated, compared to 240 (94%) children aged 8-10 and 201 (78%) aged 14-16 years from the LMR. -- The following significant results were considered to be of epidemiological importance: -- 1. Boys and girls, aged 8-10 and 14-16 years, in the HMR had significantly higher mean systolic and diastolic blood pressures than those in the LMR. -- 2. Body mass index (weight/height²) was significantly greater for boys and girls aged 14-16 years in the HMR than in the LMR. This risk factor was a strong discriminant between this age group in the two mortality regions. -- 3. The prevalence of elevated levels of systolic blood pressure was significantly higher for boys and girls aged 8-10 years and for boys aged 14-16 in the HMR. -- 4. Boys and girls aged 14-16 years in the HMR had a significantly higher prevalence of elevated diastolic blood pressure. -- 5. The total number of boys aged 14-16 years with one and clusters of two and three primary CHD risk factors simultaneously was significantly higher in the HMR. -- 6. The prevalence of Type IV hyperprebetalipoproteinemia was significantly higher in children living in the HMR. -- The risk of developing premature CHD in adulthood appears to be higher for chi1dren in the HMR. A primary prevention CHD program should, therefore, be started in this region. This program should employ health education as a means of improving nutrition, weight control, physical activity and preventing the onset of smoking. The effectiveness of this program, in reducing risk factor levels in a young population, should be evaluated.

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