Internet use is nearly ubiquitous among adolescents. Growing evidence suggests heavy Internet use negatively impacts health, yet the relationship between time spent on the Internet and adolescent blood pressure (BP) is unknown. We examined the association between Internet use and elevated BP in a racially diverse cross-sectional sample of 331 healthy adolescents (ages 14–17 years). Heavy Internet use was defined as ≥2 hr/day, moderate use as <2 hr/day and ≥5 days/week, and light use as <2 hr/day and ≤4 days/week. Elevated BP was defined as systolic or diastolic BP ≥90th percentile. Heavy Internet users had statistically significantly higher odds of elevated BP compared to light Internet users. School nurses can play an important role in preventing high BP through assessment of BP and other health behaviors including Internet use, and health teaching to individuals, student groups, faculty, and parents to increase awareness of the relationship between Internet use and health.
American Nurses Association. (2011). School nursing: Scope & standards of practice (2nd ed.). Washington, DC: Author.
2.
ArchboldK. H.VasquezM. M.GoodwinJ. L.QuanS. F. (2012). Effects of sleep patterns and obesity on increases in blood pressure in a 5-year period: Report from the Tucson Children's Assessment of Sleep Apnea Study. Journal of Pediatrics, 161, 26–30.
3.
AssadiF. (2012). The growing epidemic of hypertension among children and adolescents: A challenging road ahead. Pediatric Cardiology, 33, 1013–1020.
4.
BaekS. I.SoW. Y. (2011). Association between times spent on the internet and weight status in Korean adolescents. Iranian Journal of Public Health, 40, 37–43.
5.
BaoW.ThreefootS. A.SrinivasanS. R.BerensonG. S. (1995). Essential hypertension predicted by tracking of elevated blood pressure from childhood to adulthood: The Bogalusa Heart Study. American Journal of Hypertension, 8, 657–665.
6.
BelangerR. E.AkreC.BerchtoldA.MichaudP. A. (2011). A U-shaped association between intensity of Internet use and adolescent health. Pediatrics, 127, e330–e335.
7.
BenerA.BhugraD. (2013). Lifestyle and depressive risk factors associated with problematic internet use in adolescents in an Arabian Gulf culture. Journal of Addiction Medicine, 7, 236–242.
8.
BerkeyC. S.RockettH. R.ColditzG. A. (2008). Weight gain in older adolescent females: The internet, sleep, coffee, and alcohol. Journal of Pediatrics, 153, 635–639, 639e1.
9.
BuschV.MandersL. A.de LeeuwJ. R. (2013). Screen time associated with health behaviors and outcomes in adolescents. American Journal of Health Behavior, 37, 819–830.
10.
CarsonV.JanssenI. (2011). Volume, patterns, and types of sedentary behavior and cardio-metabolic health in children and adolescents: A cross-sectional study. BMC Public Health, 11, 274.
11.
Cassidy-BushrowA. E.JohnsonD.JosephC. (2011). PS2-07: The association of cyberbullying with cardiovascular health in adolescents: A preliminary analysis. Clinical Medicine & Research, 9, 153–153[abstract].
12.
ChenX.WangY. (2008). Tracking of blood pressure from childhood to adulthood: A systematic review and meta-regression analysis. Circulation, 117, 3171–3180.
13.
ClarkD. J.FrithK. H.DemiA. S. (2004). The physical, behavioral, and psychosocial consequences of Internet use in college students. Computers, Informatics, Nursing, 22, 153–161.
14.
Council on School Health. (2008a). Role of the school nurse in providing school health services. Pediatrics, 121, 1052–1056.
15.
Council on School Health. (2008b). The role of the school nurse in providing school health services. The Journal of School Nursing, 24, 269–274.
16.
CuffeeY.OgedegbeC.WilliamsN. J.OgedegbeG.SchoenthalerA. (2014). Psychosocial risk factors for hypertension: An update of the literature. Current Hypertension Reports, 16, 483.
17.
DasguptaK.O’LoughlinJ.ChenS.KarpI.ParadisG.TremblayJ.PiloteL. (2006). Emergence of sex differences in prevalence of high systolic blood pressure: Analysis of a longitudinal adolescent cohort. Circulation, 114, 2663–2670.
18.
DeBellM.ChapmanC. (2006). Computer and internet use by students in 2003 (NCES 2006–065). U.S. Department of Education. Washington, DC: National Center for Education Statistics.
19.
Din-DziethamR.LiuY.BieloM. V.ShamsaF. (2007). High blood pressure trends in children and adolescents in national surveys, 1963 to 2002. Circulation, 116, 1488–1496.
20.
DormanS. M. (1997). Internet Safety for schools, teachers, and parents. Journal of School Health, 67, 355.
21.
FordC. A.NonnemakerJ. M.WirthK. E. (2008). The influence of adolescent body mass index, physical activity, and tobacco use on blood pressure and cholesterol in young adulthood. Journal of Adolescent Health, 43, 576–583.
22.
FranklinS. S. (2007). The importance of diastolic blood pressure in predicting cardiovascular risk. Journal of the American Society of Hypertension, 1, 82–93.
23.
GoldfieldG. S.KennyG. P.HadjiyannakisS.PhillipsP.AlbergaA. S.SaundersT. J.SigalR. J. (2011). Video game playing is independently associated with blood pressure and lipids in overweight and obese adolescents. PLoS One, 6, e26643.
24.
GopinathB.BaurL. A.HardyL. L.KifleyA.RoseK. A.WongT. Y.MitchellP. (2012). Relationship between a range of sedentary behaviours and blood pressure during early adolescence. Journal of Human Hypertension, 26, 350–356.
25.
GrossE. F. (2004). Adolescent Internet use: What we expect, what teens report. Journal of Applied Developmental Psychology, 25, 633–649.
26.
KelleciM.InalS. (2010). Psychiatric symptoms in adolescents with Internet use: Comparison without Internet use. Cyberpsychology, Behavior and Social Networking, 13, 191–194.
27.
KuczmarskiR. J.OgdenC. L.GuoS. S.Grummer-StrawnL. M.FlegalK. M.MeiZ.JohnsonC. L. (2002). 2000 CDC growth charts for the United States: Methods and development. Vital and Health Statistics Series11, 1–190.
28.
LimJ. A.GwakA.R.ParkS. M.KimD. J.ChoiJ. S. (2014). P-71 The association between internet addiction and aggression/impulsiveness in adolescents. Alcohol and Alcoholism, 49, i67[abstract].
29.
MarshallS. J.BiddleS. J.GorelyT.CameronN.MurdeyI. (2004). Relationships between media use, body fatness and physical activity in children and youth: A meta-analysis. International Journal of Obesity and Related Metabolic Disorders, 28, 1238–1246.
30.
MarshallS. J.GorelyT.BiddleS. J. (2006). A descriptive epidemiology of screen-based media use in youth: A review and critique. Journal of Adolescence, 29, 333–349.
31.
MorenoM. A.JelenchickL.CoxE.YoungH.ChristakisD. A. (2011). Problematic internet use among US youth: A systematic review. Archives of Pediatrics & Adolescent Medicine, 165, 797–805.
32.
MoyerV.A.U.S. Preventive Services Task Force. (2013). Screening for primary hypertension in children and adolescents: U.S. Preventive Services Task Force recommendation statement. Annals of Internal Medicine, 159, 613–619.
33.
MuntnerP.HeJ.CutlerJ. A.WildmanR. P.WheltonP. K. (2004). Trends in blood pressure among children and adolescents. Journal of the American Medical Association, 291, 2107–2113.
34.
MusanteL.TreiberF. A. (2000). The relationship between anger-coping styles and lifestyle behaviors in teenagers. Journal of Adolescent Health, 27, 63–68.
35.
NarangI.ManlhiotC.Davies-ShawJ.GibsonD.ChahalN.StearneK.McCrindleB. W. (2012). Sleep disturbance and cardiovascular risk in adolescents. Canadian Medical Association Journal, 184, E913–E920.
National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. (2004). The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics, 114, 555–576.
38.
NaylorP. J.McKayH. A. (2009). Prevention in the first place: Schools a setting for action on physical inactivity. British Journal of Sports Medicine, 43, 10–13.
39.
NguyenT. T. (2009). Internet safety: Implications for teacher education. Paper presented at the Society for Information Technology & Teacher Education International Conference 2009, Charleston, SC. Retrieved fromhttp://www.editlib.org/p/30854
40.
NorrisM. L. (2007). HEADSS up: Adolescents and the Internet. Paediatrics & Child Health, 12, 211–216.
41.
OgdenC. L.CarrollM. D.KitB. K.FlegalK. M. (2012). Prevalence of obesity and trends in body mass index among US children and adolescents, 1999-2010. Journal of the American Medical Association, 307, 483–490.
42.
ParsadB.JonesJ. (2005). Internet access in U.S. public schools and classrooms: 1994-2003. Education Statistics Quarterly, 7, 45–53.
43.
PateR. R.DavisM. G.RobinsonT. N.StoneE. J.McKenzieT. L.YoungJ. C. (2006). Promoting physical activity in children and youth: A leadership role for schools. A scientific statement From the American Heart Association Council on Nutrition, Physical Activity, and Metabolism (Physical Activity Committee) in collaboration with the Councils on Cardiovascular Disease in the Young and Cardiovascular Nursing. Circulation, 114, 1214–1224.
RomerD.BagdasarovZ.MoreE. (2013). Older versus newer media and the well-being of United States youth: Results from a national longitudinal panel. Journal of Adolescent Health, 52, 613–619.
46.
RosnerB.CookN. R.DanielsS.FalknerB. (2013). Childhood blood pressure trends and risk factors for high blood pressure: The NHANES experience 1988-2008. Hypertension, 62, 247–254.
47.
SchneiderM.DuntonG. F.CooperD. M. (2007). Media use and obesity in adolescent females. Obesity, 15, 2328–2335.
48.
SnyderT. D.DillowS. A. (2013). Digest of education statistics 2012(NCES 2014-015). Washington, DC: National Center for Education Statistics, Institute of Education Sciences, U.S. Department of Education.
49.
SundstromJ.NeoviusM.TyneliusP.RasmussenF. (2011). Association of blood pressure in late adolescence with subsequent mortality: Cohort study of Swedish male conscripts. British Medical Journal, 342, d643.
WardleJ.RobbK.JohnsonF. (2002). Assessing socioeconomic status in adolescents: The validity of a home affluence scale. Journal of Epidemiology and Community Health, 56, 595–599.
52.
WashburnR. A.AdamsL. L.HaileG. T. (1987). Physical activity assessment for epidemiologic research: The utility of two simplified approaches. Preventive Medicine, 16, 636–646.
53.
WongS. N.Tz SungR. Y.LeungL. C. (2006). Validation of three oscillometric blood pressure devices against auscultatory mercury sphygmomanometer in children. Blood Pressure Monitoring, 11, 281–291.
54.
YenC. F.HsiaoR. C.KoC. H.YenJ. Y.HuangC. F.LiuS. C.WangS. Y. (2010). The relationships between body mass index and television viewing, internet use and cellular phone use: The moderating effects of socio-demographic characteristics and exercise. International Journal of Eating Disorders, 43, 565–571.
55.
ZhangY. X.ChenM.XueL. H.ZhaoJ. S.ChuZ. H. (2013). Comparison of body shape and physical activity among adolescents with normotensive and elevated blood pressure in Shandong, China. Annals of Human Biology, 40, 88–93.
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