Prevalence of hypertension and risk factors among school children in Kerala, India

Abstract

INTRODUCTION Systemic hypertension is an important health problem in childhood with an estimated population prevalence of 1-2% in the developed countries. Hypertension could have its origin in childhood and go unnoticed unless specifically diagnosed during this childhood period. Nutritional surveys, in the USA showed a significant secular increase in systolic and diastolic blood pressures. 1 The reasons for the increase in blood pressure are attributed to obesity, change in food habits, decreased physical activity and increasing academic stress. Small surveys in school children in India suggest a prevalence ranging from 2-5%. 2 Elevated blood pressure whether systolic or diastolic in both sexes and at any age is a contributor of cardiovascular diseases. 3 Identifying and modifying the risk factors reduces the incidence and complications in adolescents and adulthood. This study was conducted to know the prevalence and risk factors of hypertension in children in Thrissur city in central Kerala. ABSTRACT Background: Early diagnosis of hypertension in childhood is an important strategy in its control and hypertension may begin in childhood, perhaps even in infancy. The objective of the study was to To know the prevalence of hypertension and risk factors among school going children between 5-10 yrs of age in Thrissur District, Kerala India. Methods: 1610 school children of the age group 5-10 years from 6 schools of rural and urban regions were selected by purposive sampling method. They were subjected to anthropometric measurements after getting informed consent. Blood pressure measurements were taken using mercury sphygmomanometer as per recommendation. Hypertension is considered when blood pressure is more than 95th percentile adjusted for age and gender based on BP percentile charts. Results: Total prevalence of hypertension in this study was 4.5% and Pre-hypertension is 5.8 %. Urban school children with hypertension were 7.52% against rural were 1-2% , pre hypertension in urban school children were 9.4% ,rural 1.84% Hypertension in males were 4.31% and in females were 4.65% Prevalence of obesity in hypertension was 11 .32% against normotensive 4.61% (P <0.05). Prevalence of hypertension in children with family history of hypertension, diabetes was high and statistically significant. Conclusions: We found childhood obesity, family history of diabetes mellitus ischemic heart disease and CVA had strong association with childhood hypertension. Awareness of hypertension was very low. Periodic measurements should be done in schools to identify the high risk group of children and adolescents who can develop hypertension.