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research letters

Indian Pediatr 2012;49: 755-756

Prevalence of Prehypertension and Hypertension among Urban and Rural School Going Children


D Narayanappa , HS Rajani, KB Mahendrappa and VG Ravikumar

Department of Pediatrics JSS Medical College, JSS University, Mysore, India.
Email: [email protected]



This school based cross sectional study was done to estimate the prevalence of prehypertension and hypertension among apparently healthy school children in urban and rural Mysore. Prevalence of prehypertension and hypertension was 2.9% and 2.8% in urban children and 2.8% and 2% in rural children with no statistically significant difference between them.

Key words: Children, Hypertension, Prehypertension


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 95
th 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.

References

1. Kaerney PM, Whelton M, Reynolds SK, Muntner P, Whelton PK, He J. Global burden of hypertension: Analysis of worldwide data. Lancet. 2005; 365:217-23.

2. National High Blood Pressure Education Programme Working Group. The Fourth Report on the Diagnosis, Evaluation and Treatment of High Blood Pressure in Children and Adolescents. Pediatrics. 2004;114:555-76.

3. Khadlikar VV, Khadlikar AV, Choudhury P, Agarwal KN, Ugra D, Shah NK. IAP Growth Monitoring Guidelines for Children From Birth to 18 Years. Indian Pediatr. 2007;44:187-96.

4. Bagga A, Jain R, Vijayakumar M, Kanitkar M, Ali U. Evaluation and management of hypertension. Indian Pediatr.2007;44:103-21.

5. Gupta AK, Ahmad AJ. Childhood obesity and hypertension. Indian Pediatr. 1990;27:333-7.

6. Sharma A, Grover N, Kaushik S, Bharadwaj R, Sankhyan N. Prevalence of hypertension among school children in Shimla. Indian Pediatr. 2010;47:873-6.

7. Sachdev Y. Normal blood pressure and hypertension in Indian children. Indian Pediatr. 1984;21:41-8.

8. Mitra S, Bhattacharya H, Bhattacharya R, Mondal K, Patra DK, Nath S. Prevalence of overweight and hypertension among rural and urban school going children and association of hypertension with overweight. J Indian Med Assoc. 2011;109:564-5.

9. Gupta R. Trends in hypertension epidemiology in India. Journal of Human Hypertension. 2004;18:73-8.

 

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