Prolonged screen watching behavior is associated with high blood pressure among children and adolescents: a systematic review and dose–response meta-analysis

Abstract

Background: Numerous cardio-metabolic risk factors influence screen-related behaviors in children and adolescents. Numerous studies with inconsistent results revealed a relationship between blood pressure and screen time in the children and adolescents. This systematic review and meta-analysis summarized the data regarding the relationship between screen time and hypertension (HTN) in children and adolescents. Methods: We examined three electronic databases, including Scopus, PubMed, and Embase to find the recent research on the relationship between screen time and HTN up to 19 July 2022. Twenty papers were included in the final two-class and dose–response meta-analysis. We conducted subgrouping to identify the source of heterogeneity. Results: The highest category of screen time increased the odds of HTN by 8% [odds ratio (OR): 1.15; 95% confidence interval (CI): 1.08, 1.23; P < 0.001; I 2 = 83.20%] and 1.9 mmHg increase in systolic blood pressure [weighted mean difference (WMD): 1.89; 95% CI: 0.18–3.62; P = 0.030; I 2 = 83.4]. However, there was no significant difference in diastolic blood pressure. Moreover, screen time in hypertensive children and adolescents was 0.79 h (47.4 min) higher than normotensive subjects (WMD: 0.79; 95% CI: 0.02, 1.56; P = 0.046; I 2 = 92.8). A departure from linearity was observed between increased screen time [digital video discs, personal computers, and video games and HTN (P nonlinearity = 0.049). Conclusion: This systematic meta-analysis review is the first to demonstrate a positive correlation between screen time and HTN in children and adolescents.