evaluation of the effects of time spent on the internet on ambulatory blood pressure parameters in adolescents aged 12-18 years

Introduction: Hypertension is an important public health issue with an increasing frequency among children and adolescents. Although various rates are reported its prevalance is reported to be 3-4 % in developed countries. The recent increase in the prevalence of childhood hypertension is associated with changes in eating habits, decrease in physical activity due to sedentary lifestyle, accompanying obesity and increased stress. It has also been demonstrated that internet use among children and adolescents has increased significantly in recent years. Studies have revealed that time spent on the Internet poses a potential risk for high blood pressure. It has also been suggested that time spent on the Internet may be associated with decreased physical activity, increased overweight and/ or obesity, and decreased sleep quality. Recent studies also demonstrated that that playing video games is also associated with obesity, changes in lipid profile and high blood pressure. Objective: The primary aim of this study; is to determine the effect of the time spent on the internet on the parameters of 24-hour ambulatory blood pressure monitoring in patients aged 12-18 years with primary hypertension. The secondary aim of the study is to determine the effect of video games on blood pressure parameters. Although there are studies evaluating the effect of time spent on the Internet on office blood pressure measurements, there are not enough studies examining the relationship between 24-hour blood pressure measurements. In this study, we aimed to determine the role of internet addiction and video games in blood pressure elevation in children and adolescents by ambulatory blood pressure monitoring measurements. Patients and Methods: Our study was conducted with patients who were referred to Ankara City Hospital Pediatric Nephrology outpatient clinic with a prediagnosis of hypertension and who underwent 24-hour ambulatory blood pressure monitoring (ABPM) between September 1, 2021 and December 31, 2021. We used prospective and observational methods and evaluation scales. Volunteered female and male patients aged 12-18 years were included in the study, and those with diseases that could lead to secondary hypertension such as chronic kidney disease, chronic heart disease, and endocrinological diseases were excluded from the study. In addition, children with known psychiatric diseases were also excluded from the study. Demographic data, clinical and laboratory findings of the patients were obtained from hospital records. Young Internet Addiction Scale and Video Game Scale scores and ABPM parameters were compared. Results: Of the 107 patients included in our study, 40 were girls and 67 were boys. The mean age was 14.9±1.8 years. When body mass indexes were evaluated, 37 patients (34.6%) were obese, 37 patients (34.6%) were overweight, and 33 patients (30.8%) were at normal weight. According to ABPM measurements, 43 (40.2%) of 107 patients were normotensive, 24 (22.4%) prehypertensive, and 40 (37.4%) hypertensive. There was no significant difference between Young's Internet Addiction Test and Video Game Scale scores of normotensive, prehypertensive and hypertensive patients. When the relationship between test scores and different parameters of ABPM was evaluated, it was detected that as the test scores increased, the overall mean systolic blood pressure increased, but it did not reach a statistically significant state. As Young's Internet Addiction test score increased, it was determined that the maximum daytime blood pressure increased. We also demonstrated that the maximum daytime blood pressure in patients with normal weight was increased as Young's internet score increased. Conclusion: With the developing technology in recent years, the use of the internet has increased and this has affected the duration of screen time of children and adolescents. Sedentary life style has increased the frequency of hypertension along with obesity. Both video game addiction and increased time spent on the Internet; increase sedentary life and obesity and may lead to the development of hypertension. Therefore, we think that internet and screen addiction should be investigated in pediatric and adolescent patients with primary hypertension. Key Words: Adolescent, Ambulatory Blood Pressure Monitoring, Childhood, Hypertension , Internet Addiction