Table 1 The characteristics of included studies in the meta-analysis

[42]

Plos One/2020

Solomon-Moore E/UK

School/1283 + 797

Cross-sectional

Prospective (OR reported)

Children

9–11

 ≤ 95th for age, sex and height

Omron 907

Video games/PC/TV/movies

Accelerometer

No correlation between sedentary time and HTN was reported. There was a significant positive relationship between sedentary time and high SBP

[40]

Scand J Public Health

Pederson J/Denmark

Community/964 + 963

Cross-sectional

Children

3–5

 ≤ 95th for age, sex and height

Electronic oscillometric

Video games/PC/tablet/TV/movies

Parent reported-daytime ST

No association between sedentary time and HTN was reported. A positive association between pre-bedtime ST and HTN was reported [1.57 (95% CI 1.02; 2.42) and 1.82 (95% CI 1.18; 2.89)], respectively, for 2–5 days/week and more than 6 times/week

[24]

BMC Pediatrics/2019

Zou Y/China

School/3737

Cross-sectional

Adolescents

12–15

 ≤ 95th for age, sex and height

Mercury Sphygmomanometer

Smartphone addiction

Smartphone Addiction Scale short version

Smartphone addiction was positively associated with HTN (OR = 2.205, 95% CI: 1.273–3.820)

[6]

Cien Saude Colet/2018

de Oliveira/Brazil

School/2524 + 3773

Cross-sectional

Adolescents

14–17

 ≤ 95th for age, sex and height

Omron HEM 742

Video games/PC/tablet/TV/movies

Self-reported

TV viewing was associated with high BP among boys. No significant association between ST and HTN among girls was reported

[4]

J Am Soc Hypert/2018

Karatazi K/Greece

School/1243 + 1230

Cross-sectional

Children + adolescents

9–13

 ≤ 95th for age, sex and height

Mercury Sphygmomanometer

Video games/PC/tablet/TV/movies

Self-reported

Boys in isolated systolic HTN had higher ST compared with others (P = 0.002); also, higher ST was associated with significantly higher odds of ISH (1.13 (1.04–1.23). No significant association between ST and HTN was observed

[17]

BMC Pediatrics/2018

Barstad LH/Norway

Clinic/268

Cross-sectional

Adolescents

12–18

 ≤ 95th for age, sex and height

Digital oscillimetric device, Dinamap ProCare

Time in front of the TV- or PC

Self-reported

Those in high ST group had higher SBP

[43]

Biomed Res Int/2017

WyszyNsk J/Poland

Community/568

Cross-sectional

Children + adolescents

7–18

 ≤ 95th for age, sex and height

Mercury Sphygmomanometer

Video games/PC/TV/movies

Self-reported

More than 2 h/d ST in school days was associated with higher odds of HTN [2.74 (1.25–6.04)]

[44]

Nutrients/2017

Gui ZH/China

Community/79,725

Cross-sectional

Children + adolescents

6- 17

 ≤ 95th for age, sex and height

Mercury Sphygmomanometer

Video games/PC/TV/movies

Self-reported

Those with more than 2h/d ST had higher odds of pre-HTN and HTN (5% and 6% higher risk, respectively)

[45]

Int J Obes/2017

Cureau FV/Brazil

School/36,956

Cross-sectional

Children + adolescents

12–17

 ≤ 95th for age, sex and height

Omron HEM 705

Video games/PC/TV

Self-reported

Those with more than 6 h/d ST had higher odds of HTN [1.21 (1.08–1.35); P = 0.003]

[46]

Iran J Public Health/2015

Safiri S/Iran

School/5625

Cross-sectional

Children + adolescents

10–18

 ≤ 95th for age, sex and height

Mercury Sphygmomanometer

TV/VCDs/PC

Self-reported

High SBP and DBP in those with high ST (P < 0.001)

[20]

Blood Pressure/2015

Christofaro DGD/Brazil

School/1231

Cross-sectional

Children + adolescents

10–18

 ≤ 95th for age, sex and height

Mercury Sphygmomanometer

TV/VCDs/PC

Self-reported

Higher odds of HTN (1.68) and higher ST in hypertensive compared with normotensive children and adolescents

[19]

Int J Obes/2014

NE Berentzen/Netherland

School/2651

Cross-sectional

Children + adolescents

11–12

 ≤ 95th for age, sex and height

Omron M6

TV/PC

Self-reported

No significant difference in SBP or DBP in highest versus lowest ST quartiles

[47]

Am J Prevent Med/2013

Stamatakis E/Portugal

School/2515

Cross-sectional

Children + adolescents

2–12

 ≤ 95th for age, sex and height

Omron M7

TV/VCDs/PC

Parent -reported

High SBP and DBP in those with high than 2 h/d screen behaviors

[18]

Psychosom Med/2013

Berendes A/Germany

Community/825

Cross-sectional

Children + adolescents

11–17

 ≤ 95th for age, sex and height

Sphygmomanometer

TV/VCDs/PC

Self-reported

Higher odds of HTN among those with more than 2 h/d TV, VCD and more than 0.5 h/d PC exposure (P < 0.001)

[48]

J Korean Med Sci/2012

Byun W/Korea

Community/577

Cross-sectional

Children + adolescents

12 -18

 ≤ 95th for age, sex and height

Sphygmomanometer

TV/VCDs/PC

Self-reported

No significant association between odds of HTN and screen behaviors

[41]

BMC Public Health/2011

Carson V/USA

Community/2527

Cross-sectional

Children + adolescents

6–19

Highest versus lowest BP quartiles

Sphygmomanometer

TV/PC

Accelerometer

No significant association between odds of HTN and screen behaviors

[49]

J Sports Sci/2010

Ullrich-French SC [49]/USA

School/153

Cross-sectional

Adolescents

11–15

 ≤ 95th for age, sex and height

Sphygmomanometer

TV/VCDs/PC

Self-reported

Higher SBP in those with more than 2 h/d screen behaviors (P < 0.001)

[50]

Arch Ped Adol Med/2010

Hardy LL/Australia

School/496

Cross-sectional

Adolescents

14–17

 ≤ 95th for age, sex and height

Mercury Sphygmomanometer

TV/DVDs/videos/PC for recreation

Self-reported

Odds of higher DBP in boys with more than 2 h/d screen behaviors [3.30 (1.35–8.12; P < 0.001)]

[51]

J Hum Hyper/2009

Lazarou C/Cyprus

School/622

Cross-sectional

Adolescents

10–13

 ≤ 95th for age, sex and height

Mercury Sphygmomanometer

TV

Self-reported

No significant association between odds of HTN and TV watching

[26]

Am J Prev Med/2007

Pardee PE/USA

Clinic/546

Cross-sectional

Children + adolescents

4–17

 ≤ 95th for age, sex and height

Self-reported

TV

Parent and self-reported

Higher odds of HTN among those with 2–4 h/d and more than 4 h/d compared with those with less than 2 h/d TV watching [OR:2.54 (1.51–4.29 and OR:3.29 (1.95–5.59, respectively]