As India is undergoing a
rapid epidemiological transition [1,2], the burden of chronic
diseases is over taking the burden of infectious diseases [1-3]. The
awareness that essential hypertension has its origin in childhood
has resulted in increased emphasis on screening asymptomatic
children. The present study was conducted to evaluate the prevalence
of hypertension and prehypertension among apparently healthy school
children in urban and rural Mysore. In this school based
cross-sectional study, 1000 children from urban schools in Mysore
city and 1000 children from rural school in Suttur (Mysore
district), between the age group of 10-16 years were included (with
upper and lower limit of 95% CI at ± 0.02). Anthropometric
measurements were taken by two medical graduates under supervision
of co-investigators. Agarwal charts of BMI for age and sex were used
as reference standards. Children with BMI above 95th
percentile were considered obese, those between 85th
and 95th percentile were
considered overweight [3]. Blood pressure measurements were taken
using a mercury sphygmomanometer as per recommendations of American
Heart Association [4]. The blood pressure was compared to age, sex
and height percentile standards given by the report of Fourth task
force on hypertension control in children [4]. Hypertension was
diagnosed if blood pressure either systolic, diastolic or both was
more than 95th
percentile for age, sex and height percentile and between 90 and 95th
percentile was taken as pre hypertension [4]. Ethical clearance was
obtained from institutional ethical committee. A written informed
consent was obtained from the head of the Institutions and parents.
Statistical analysis was done using EPIINFO software.
Out of total 1000 urban children, 567 were males
and out of 1000 rural children, 461 were males. The overall
prevalence of prehypertension and hypertension was 2.8% and 2.4%
respectively in concordance with other studies [5-8]. Prevalence of
pre-hypertension and hypertension was 2.9% and 2.8% in urban
children and 2.8% and 2% in rural children respectively. Although
there is generally lower prevalence of hypertension in rural Indian
population, there has been steady increase over time in rural
population as well [9]. This is probably due to rapid urbanization
of rural India which has altered the dietary habits, level of
physical activity and social pressures in life [9]. In our study,
there was no statistically significant difference in the prevalence
of prehypertension and hypertension between rural and urban
children. This is in contrast to other studies [6,8] where
prevalence of hypertension was more among urban children compared to
rural children.
These trends of increasing prevalence of
hypertension, prehypertension in urban as well as rural population
calls for a collective effort targeted at recognizing hypertension
and prehypertension in asymptomatic children.
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