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Prevalence of sustained hypertension and obesity in urban and rural school going children in Ludhiana
Abstract
Increasing trend of hypertension is a worldwide phenomenon. The data on sustained hypertension in school going children is scanty in India. The present study was conducted to evaluate the prevalence of sustained hypertension and obesity in apparently healthy school children in rural and urban areas of Ludhiana using standard criteria.
A total of 2467 apparently healthy adolescent school children aged between 11-17 years from urban area and 859 students from rural area were taken as subjects. Out of total 3326 students, 189 were found to have sustained hypertension; in urban areas prevalence of sustained hypertension was 6.69% (n=165) and in rural area it was 2.56% (n=24). Males outnumbered females in both rural and urban areas. The mean systolic and diastolic blood pressure of hypertensive population in both urban and rural population was significantly higher than systolic and diastolic blood pressure in their normotensive counterparts (urban normotensive systolic blood pressure:115.48+/-22.74 mmHg, urban hypertensive systolic blood pressure: 137.59+/-11.91 mmHg, rural normotensive systolic blood pressure: 106.31+/-19.86 mmHg, rural hypertensive systolic blood pressure: 131.63+/-10.13 mmHg, urban normotensive diastolic blood pressure: 74.18+/-17.41 mmHg, urban hypertensive diastolic blood pressure: 84.58+/-8.14 mmHg, rural normotensive diastolic blood pressure: 68.84+/-16.96 mmHg, rural hypertensive diastolic blood pressure: 79.15+/-7.41 mmHg). Overweight populationwas significantly higher in urban area. There were 287 (11.63%) overweight students and 58 (2.35%) were obese. In rural population overweight and obese students were 44 (4.7%) and 34 (3.63%) respectively. There was significant increase in prevalence of hypertension in both rural and urban population with increased body mass index in urban students; those with normal body mass index had prevalence of hypertension of 4.52% (n=96), in overweight it was 15.33% (n=44) and in obese it was 43.10% (n=25). In rural area, the overweight students showed prevalence of sustained hypertension in 6.82% (n=3) and in obese group it was 61.76% (n=21). None of the student with normal body mass index in rural area was found to be hypertensive. The mean body mass index of hypertensive population in both rural and urban areas was significantly higher than respective normotensive population (mean body mass index in urban normotensive group: 20.34+/-3.72 kg/m2, hypertensive group: 24.91+/-4.92 kg/m2; mean body mass index in rural normotensive group: 18.41+/-3.41 kg/m2, hypertensive group: 21.37+/-3.71 kg/m2, p<0.01).
Prevalence of sustained hypertension is on the rise in urban area even in younger age groups. Blood pressure is frequently elevated in obese children as compared to lean subjects. This is possibly related to their sedentary lifestyle, altered eating habits, increased fat content of diet and decreased physical activities.
... As a result, the systolic and diastolic blood pressures increased because they decreased the pulsation of the artery walls [33]. Several studies have shown that the prognostic significance of systolic pressure increases with age, at around 60 years, there is hardening of the large arteries resulting in a decrease in diastolic pressure and an increase in pulse rate [34,35]. In this study, the age of women with hypertension in urban areas is younger than in rural areas, which is under 60 years on average. ...
... The difference in yield in rural and urban areas might be related to the sedentary lifestyle of the people, resulting in a decrease in physical activity in urban communities [35]. Changing eating habits, an increase in the fat content of food, and a low in physical activity lead to increased obesity in society [35,42]. ...
... The difference in yield in rural and urban areas might be related to the sedentary lifestyle of the people, resulting in a decrease in physical activity in urban communities [35]. Changing eating habits, an increase in the fat content of food, and a low in physical activity lead to increased obesity in society [35,42]. Changes in diet, work, and lifestyle were some of the possible contributors to the increase of hypertension in urban areas [43]. ...
Introduction: Hypertension is a major risk factor for cardiovascular disease. A high prevalence of hypertension is found in elderly women. Rural areas have different characteristics from urban areas. Therefore, it is necessary to identify risk factors for hypertension in rural and urban elderly women for optimal therapy management. Methods: This cross-sectional study was conducted in rural (Banyuwangi district) and urban (Surabaya city) areas, East Java, Indonesia. The study was carried out in 2015-2016 in women aged ≥45 years, residing in an area for ≥10 years, and willing to collect urine for 24 hours. Respondents consisted of 54 older adults from rural areas and 51 older adults from urban areas who actively participate in the integrated healthcare center for the elderly. The independent t-test and multivariate logistic regression were used to analyze the data. Results: The prevalence of hypertension in the rural area was 27.8% and in the urban area was 37.25%. The risk factors for hypertension in the urban area were urine sodium level (AOR=1.02, 95% CI=1.001-1.04, p-value=0.043), urine potassium level (AOR=0.88, 95% CI=0.78-0.999, p-value=0.022), and Body Mass Index (AOR=1.26, 95% CI=1.06-1.49, p-value=0.008). Meanwhile, the factor associated with hypertension in the rural area was age (AOR=1.08, 95% CI=1.003-1.16, p-value=0.042). Conclusion: The prevalence of hypertension in the urban area was higher than in the rural area. There were differences in risk factors for hypertension that occurred both in rural and urban areas. However, risk factors in both areas are equally important to overcome. Collaboration from multiple stakeholders and sectors is urgently needed, such as the Public Health Center, Integrated Assistance Post for Non-Communicable Diseases, and the local health office.
... As India is undergoing rapid epidemiological transition, the burden of chronic diseases is increasing [1,2,3,4]. The fact that essential hypertension has its origin in childhood has resulted in increased emphasis on screening asymptomatic children [5,6,7]. ...
... In another study done in Mysore district, Prevalence of pre-hypertension and hypertension was 2.9% and 2.8% in urban children and 2.8% and 2% in rural children respectively which was less compared to this study [16]. The prevalence of overweight and obesity in our study was 3.3% and 0.2%, respectively which was little less compared to other school based data in India, which demonstrated prevalence of overweight and obesity in the range of 5.6% to 2.4% among children and adolescents [1,7,17]. The prevalence of overweight and obesity in a study done in urban school children of Mysore district was 11% and 4.4%, respectively which was higher compared to the present study [4]. ...
... Various other studies have reported statistically significant association between hypertension and obesity [1,7,17]. ...
Introduction: Hypertension is a major public health problem found to have origin very early in life but remains asymptomatic warranting screening of all children. Objective: To study the prevalence of Pre hypertension and Hypertension among traditional Jenukuruba tribal children in Mysore district. Methods: Community based cross sectional study done over a period of 2 years from. About 3864 children between the age group of 2-15 years of Jenukuruba tribal community were enrolled in the study. Anthropometric measurements were recorded. Weight for age, Height for age and BMI were calculated. Blood pressure recording was done by research assistants and classified using American Heart Association fourth task force recommendations. Results: The point prevalence of systolic prehypertension and hypertension among tribal children between 2-15 years was 6.9% and 2.3% respectively and the point prevalence of diastolic prehypertension and hypertension was 9.6% and 4.1% respectively. Conclusion: The prevalence of pre hypertension and hypertension in tribal children is similar and comparable to urban population.
... Several studies have proposed an association between obesity and high BP, including increased cardiovascular risk factors. 1 6 9 15-18 A study conducted in North India 10 years ago showed a high prevalence of obesity (2.3% urban and 3.6% rural areas) and hypertension (6.7% urban and 2.6% rural areas) in adolescent population, with a significant increase in the prevalence of hypertension among overweight (15.3% urban and 6.82% rural areas) and obese (43.1% urban and 61.76% rural areas) population. 16 However, current data in India regarding the changes in the prevalence of sustained hypertension and obesity and their association with cardiovascular risk factors are limited, particularly among children and adolescents from urban and rural areas. This study aimed to determine the prevalence of sustained hypertension and obesity and their risk factors among urban and rural adolescents aged 11-17 years in Ludhiana, North India. ...
... Previously, in 2004 we conducted the first cross-sectional study in Ludhiana to determine the prevalence of obesity and hypertension among school children, which revealed a high prevalence of obesity (2.3% urban and 3.6% rural areas) and hypertension (6.7% urban and 2.6% rural areas). 16 The present study is a repeated cross-sectional study, undertaken in the same urban and rural areas of Ludhiana, among school-going adolescents aged 11-17 years, between 15 March 2016 and 31 July 2017 (nearly after a decade of the first school survey). ...
... The prevalence of hypertension in school children in the same catchment area was previously found to be 6.7% in urban and 2.6% in rural areas in 2004. 16 In our previous study, the prevalence of obesity was calculated as 14% and 9% in urban and rural school children, respectively. 16 The sample size for the current survey was calculated using OpenEpi V.3.03 software, using the prevalence of obesity at 80% power and 5% level of significance. ...
Objective
Recent data on sustained hypertension and obesity among school-going children and adolescents in India are limited. This study evaluates the prevalence of sustained hypertension and obesity and their risk factors among urban and rural adolescents in northern India.
Setting
A school-based, cross-sectional survey was conducted in the urban and rural areas of Ludhiana, Punjab, India using standardised measurement tools.
Participants
A total of 1959 participants aged 11–17 years (urban: 849; rural: 1110) were included in this school-based survey.
Primary and secondary outcome measures
To measure sustained hypertension among school children, two distinct blood pressure (BP) measurements were recorded at an interval of 1 week. High BP was defined and classified into three groups as recommended by international guidelines: (1) normal BP: <90th percentile compared with age, sex and height percentile in each age group; (2) prehypertension: BP=90th–95th percentile; and (3) hypertension: BP >95th percentile. The Indian Academy of Pediatrics classification was used to define underweight, normal, overweight and obesity as per the body mass index (BMI) for specific age groups.
Results
The prevalence of sustained hypertension among rural and urban areas was 5.7% and 8.4%, respectively. The prevalence of obesity in rural and urban school children was 2.7% and 11.0%, respectively. The adjusted multiple regression model found that urban area (relative risk ratio (RRR): 1.7, 95% CI 1.01 to 2.93), hypertension (RRR: 7.4, 95% CI 4.21 to 13.16) and high socioeconomic status (RRR: 38.6, 95% CI 16.54 to 90.22) were significantly associated with an increased risk of obesity. However, self-reported regular physical activity had a protective effect on the risk of obesity among adolescents (RRR: 0.4, 95% CI 0.25 to 0.62). Adolescents who were overweight (RRR: 2.66, 95% CI 1.49 to 4.40) or obese (RRR: 7.21, 95% CI 4.09 to 12.70) and reported added salt intake in their diet (RRR: 4.90, 95% CI 2.83 to 8.48) were at higher risk of hypertension.
Conclusion
High prevalence of sustained hypertension and obesity was found among urban school children and adolescents in a northern state in India. Hypertension among adolescents was positively associated with overweight and obesity (high BMI). Prevention and early detection of childhood obesity and high BP should be strengthened to prevent the risk of cardiovascular diseases in adults.
... A study in the United States found significantly higher rates of obesity among rural children [37]. Another study in Ludhiana found that the prevalence of persistent hypertension is increasing in urban areas, even in younger age groups [38]. In addition, obese children often have higher blood pressure compared to thin subjects [38]. ...
... Another study in Ludhiana found that the prevalence of persistent hypertension is increasing in urban areas, even in younger age groups [38]. In addition, obese children often have higher blood pressure compared to thin subjects [38]. In a study conducted in Vietnam, the prevalence of overweight and obesity was found to be higher in urban areas [39]. ...
Background
The purpose of this study was to determine the eating behaviors, obesity and physical activity status of children of similar ages living in rural and urban areas and to examine these relationships during the coronavirus disease (COVID-19) pandemic process.
Method
The research was conducted using the scanning model. The research group consists of children living in rural and urban areas in Turkey. The sample of the study consists of a total of 733 adolescent participants, 351 females (47.9%) and 382 males (52.1%). After anthropometric measurements were made, the Physical Activity Questionnaire for older children and the Yale Food Addiction Scale for children 2.0 were used to determine the food addiction and physical activity status of children during the COVID19 pandemic process. Since the groups were homogeneously distributed, independent samples t -test and Pearson correlation test were used.
Result
In terms of food addiction and physical activity levels, children living in the urban have higher scores than children living in rural areas. In addition, children living in the urban were taller and have higher body mass values than those in rural areas. In terms of physical activity level and food addiction levels, while girls living in the urban had higher activity levels than those living in rural areas, no statistically significant difference was found between the physical activity levels of boys. When evaluated in terms of general and gender, it was determined that children living in rural areas were overweight and obese at a higher rate. Obese children had higher levels of food addiction and lower physical activity levels than non-obese children.
Conclusion
In order to prevent childhood obesity, the level of food addiction should be reduced as well as increasing the level of physical activity. This study is limited in terms of cross-sectional evaluation. Future research can experimentally reveal how much obesity is reduced by methods such as exercise and diet interventions.
... females-0.34%) respectively among school going adolescents in a rural area of Kerala, India [20] while Mohan B et al in his study among children from rural areas reported a lower prevalence of 2.56% [21]. In a study done by Singh AK et al. the prevalence of systolic hypertension (SBP >140) was 7.84% and diastolic hypertension was (DBP >90) 2.15% [22]. ...
... A recent study conducted by Sreedharan J et al. reported a 14% increased risk for getting pre-hypertension or hypertension for a unit increase in BMI among youth [27]. Mohan B et al reported that hypertension among adolescents is positively associated with overweight and obesity (high BMI) [21]. The present study also supported the observation made by other authors with regard to overweight or obesity. ...
Aim: The prevalence of hypertension and obesity is increasing worldwide. Recent data on sustained hypertension and obesity among school-going children and adolescents from the state of Kerala, India are limited. The aim of the present study was to estimate the prevalence of obesity and hypertension among apparently healthy school going adolescents. Methodology: A cross-sectional survey was conducted among 252 school going adolescents aged 11-16 years (173 boys and 79 girls) selected from two private aided rural schools of Thrissur, District, Kerala, India. Measurements like height, weight, and blood pressure were done using standard guidelines. Guidelines of Indian Academy of Pediatrics and standard guidelines of blood pressure measurement using gender height specific blood pressure percentile charts were used to identify the overweight/obese and pre-hypertensive/ hypertensive adolescents respectively. Analysis was done using SPSS version 27.0. Gender wise differences were checked using chi-square and t-test. Results: Among 252 adolescents, 83 (20.7%) were either overweight or obese and pre-hypertensive or hypertensive. The overall prevalence of obesity and overweight was found to be 9.5% and 15.1% respectively. The overall prevalence of hypertension and prehypertension was found to be 15 (6.0%) and 24 (9.5%) respectively. Systolic blood pressure and diastolic blood pressure was found to be statistically lower (P<0.001) among those with normal BMI, than those with overweight or obesity. The mean systolic and diastolic BP was slightly more among boys than girls and it was not statistically significant. Conclusion: The high prevalence of hypertension, obesity and the strong association between obesity and high blood pressure seen among school-going adolescents necessitates immediate attention. Strategies should be designed and implemented for prevention, early identification, and treatment of pediatric obesity and hypertension in forestalling the morbidity/mortality from non communicable diseases and its complications.
... 16 An Indian study showed hypertension prevalences of 7.0% in urban and 2.6% in rural adolescents as well as significantly increased prevalence of hypertension with increased BMI. 17 Body mass index was found to be positively related to the risk of high SBP and DBP, with 1.9 times increased risk of high SBP and 1.2 times increased risk of high DBP in those who were either overweight or obese compared to normoweight subjects. 18 Microalbuminuria is an early sign of damage to the kidney and cardiovascular system. ...
... They also found a significant increase in prevalence of hypertension with an increased BMI. 17 Muntner et al. found that the childhood obesity epidemic was associated with the increasing prevalence of HTN. 27 Duzova et al. noted that the prevalences of overweight, obesity, and hypertension were 9.3, 8.9, and 6.1%, respectively, in schoolchildren aged 5-15years. ...
Background The prevalence of childhood overweight and obesity has increased over the last two decades due to high caloric intake and decreased physical activity which occurred in conjunction with increasing prevalence of hypertension. Microalbuminuria is an early sign of damage to the kidney and cardiovascular system. Hypertensive, overweight children have an increased chance of microalbuminuria. Objectives To assess the prevalence of overweight, hyperten-sion, and microalbuminuria in urban and rural school going children and contributing risk factors and associations.
... 16 An Indian study showed hypertension prevalences of 7.0% in urban and 2.6% in rural adolescents as well as significantly increased prevalence of hypertension with increased BMI. 17 Body mass index was found to be positively related to the risk of high SBP and DBP, with 1.9 times increased risk of high SBP and 1.2 times increased risk of high DBP in those who were either overweight or obese compared to normoweight subjects. 18 Microalbuminuria is an early sign of damage to the kidney and cardiovascular system. ...
... They also found a significant increase in prevalence of hypertension with an increased BMI. 17 Muntner et al. found that the childhood obesity epidemic was associated with the increasing prevalence of HTN. 27 Duzova et al. noted that the prevalences of overweight, obesity, and hypertension were 9.3, 8.9, and 6.1%, respectively, in schoolchildren aged 5-15years. ...
Background The prevalence of childhood overweight and obesity has increased over the last two decades due to high caloric intake and decreased physical activity. The dramatic increase in the prevalence of overweight children occurred in conjunction with increasing prevalence of hypertension. Microalbuminuria is an early sign of damage to the kidney and cardiovascular system. Hypertensive, overweight children have an increased chance of microalbuminuria.
Objectives To assess the prevalence of overweight, hypertension, and microalbuminuria in urban and rural school going children and contributing risk factors and associations.
Methods This cross-sectional study was done in schoolchildren aged 6 to 16 years, from urban and rural areas, in Bangladesh, from September 2015 untill August 2016. Subjects’ weights, heights, and blood pressures (BP) were measured. Overweight and hypertension (HTN) statuses were determined with age-appropriate standardized charts. Subjects were divided into overweight and normoweight groups to evaluate risk factors for overweight such as family history (F/H) of obesity, F/H of HTN, daily physical outdoor activities, and monthly family income by comparative analysis. All overweight children were divided into hypertensive and normotensive groups in order to compare their fasting lipid profiles, urine microalbumin, serum creatinine, and random blood sugar.
Results A total of 976 schoolchildren from urban (471, 48.3%) and rural (505, 51.7%) areas were included. Overweight was observed in 22.3% of the urban group and in 8.1% of the rural group (P
... According to the survey, men and the elderly residing in cities were found to be more prone to HTN whereas women, older age groups, and wealthier individuals were more aware of their HTN status. Among those receiving therapy for HTN, almost all (99.6%) utilized the allopathic medical model [19]. However, treatment adherence rates were lower among rural inhabitants (59.2%), while urban residents scored higher at 83.2% on this metric [20]. ...
Hypertension is a significant hazardous aspect for several diseases, like cardiovascular disease, kidney failure, and brain disease. Hypertension has become the most lethal condition globally, affecting approximately 1 billion people aged around 30-79 years worldwide. In the year 2022, India was ranked 170th for men and 193rd for women for HTN diagnosis rates among 200 countries worldwide. The main risk factor for cardiac failure and stroke is hypertension. The conventional classes of antihypertensive medications currently available have some side effects. Previously, hypertension has been discussed by various researchers using conventional drug-targeting methods such as ACE inhibitors, aldosterone inhibitors, or renin inhibitors. Recently, novel drug delivery technologies utilizing nanoparticles and new pharmacological classes like ACE2 and APA inhibitors have been studied for the medication of hypertension. In this review, we have covered the epidemiology of hypertension in India, its pathophysiology, medications used in the management of hypertension using nanotechnology, and antihypertensive drugs currently available in the market that are approved and patented. Finally, we have covered how hypertension can be managed with the help of smart devices and artificial intelligence (AI) for improved therapy.
... Similar findings were noted in present study. Mohan B et al., [13] noted a high prevalence of obesity (2.3% urban and 3.6% rural areas) and hypertension (6.7% urban and 2.6% rural areas) in adolescent population, with a significant increase in the prevalence of hypertension among overweight (15.3% urban and 6.82% rural areas) and obese (43.1% urban and 61.76% rural areas) population. ...
... Increasing trend of PHT is a worldwide phenomenon [5]. PHT is more prevalent than hypertension [6]. ...
... A similar finding was reported by a study done in Ludhiana, India were the prevalence of sustained hypertension in children aged 11-17 years was 5.68%. [16] It was reported as 5.9% in Shimla. [17] A large scale study done in three countries of India, China and Mexico showed that the prevalence of hypertension in India was 10.1%. ...
... 17 In a study done by Mohan et al, the BMI of hypertensive adolescents in both rural and urban areas were significantly higher than respective normotensive population. 18 It may be due to dyslipidemia and activation of renin angiotensin system. ...
Background: Studies based on effects of lifestyle on hypertension and obesity in adolescent age group are lacking in India. The present study was conducted to evaluate the prevalence of lifestyle associated risk factors in school going adolescents of Kendriya Vidyalaya in district Firozabad and their effects on hypertension and obesity.Methods: The study was carried out among 200 students of classes 9th and 11th in the age group of 13 to 17 years. Students were given a pre-designed questionnaire and feedback was taken about dietary practices and physical activity along with family history of hypertension and obesity. Height, weight, waist circumference, hip circumference, blood pressure was measured in all children. Effects of lifestyle associated risk factors were determined on obesity and hypertension.Results: The study documents that inappropriate dietary practices (fast food consumption, low fruit intake) and less physical activity were strongly associated with high prevalence of obesity and hypertension in the adolescents. The study also showed that adolescents with positive family history of obesity and/or hypertension are also at higher risk. There was a positive correlation between high BMI and hypertension.Conclusions: School based interventions are required to educate the adolescent children about lifestyle modifications to reduce the morbidity associated with non-communicable diseases.
... Age factor was very obvious in this study. We reported that the higher mean value of random blood sugar in males was among age group 30-39 years The transition from living in a rural vs urban area has been associated with increased levels of obesity due to changes in lifestyles [12]. Rural-urban differences in prevalence of obesity in India have been described by others and similar to our study, higher prevalence of obesity has been found in urban areas [11,13]. ...
Background: Body mass index (BMI) criteria are currently the primary focus in obesity treatment recommendations, with different treatment cutoff points based upon the presence or absence of obesity-related comorbid disease. Aim: This project aimed to explore the relationship of body mass index with blood sugar. Patients & methods: Seventy-one adult diabetic patients (36 males+35 females) were subjected to this study. Body mass index was calculated for each patient and random blood sugar was also measured. Results: The highest mean value of BMI was among male & female patients in the age group 60-69 years old, which reached 36.57 & 32.74, respectively while the mean value of random blood sugar in males was among the age group 30-39 years which reached 258.88 mg/dL. But it was 295.0mg/dL among age group >70years in females. Conclusion: It is concluded that obesity is an important risk factor for diabetes and there was a relationship between BMI and increased blood sugar
... More children with high BP were observed in the 8-to 12-year group compared with the 13-to 19-year group, similar to that observed in the NHANES. In the Canadian survey, children with high BP were younger (mean age, 10.5 years) than those with normal BP (mean age, 12.3 years).The similar prevalence of high BP in rural and urban children runs contrary to some earlier data, which indicated that the prevalence of high BP in children residing in urban regions was almost twice that observed in children from rural regions.36,37 The higher prevalence of high BP in rural areas, which was observed in the current CNNS, may be attributable to their lower socioeconomic status as well as the rapid urbanization of rural India, resulting in altered obesogenic dietary habits and lower level of physical activity. ...
Importance:
High blood pressure (BP) in children and adolescents is becoming one of the most common health conditions worldwide and is much more widely prevalent than previously thought.
Objective:
To estimate the prevalence of high BP in adolescents in India and identify associated factors.
Design, setting, and participants:
This cross-sectional study is a secondary analysis of data from the Comprehensive National Nutrition Survey (CNNS, 2016-2018), which used a multistage, stratified, probability proportion to size cluster sampling design to enroll a nationally representative sample of households and individuals aged 10 to 19 years across all states and union territories of India. Adolescents with acute or chronic illness, physical deformity, mental illness, or cognitive disability were excluded from the survey. Because BP was measured only in children between 10 and 19 years of age, only data from children within this age group were included for secondary analyses. Data analysis was performed from March 2021 to April 2022.
Exposures:
Anthropometry.
Main outcomes and measures:
On the basis of the 2017 American Academy of Pediatrics guidelines, high BP was defined as stage 1 and 2 hypertension, with BP above the 95th percentile in children younger than 13 years and greater than 130/80 mm Hg in children 13 years or older. The association of age, sex, region, socioeconomic status, body mass index, fasting blood glucose, hemoglobin A1c, and lipid profile with high BP were examined using log binomial regression.
Results:
Among 16 182 eligible children aged 10 to 19 years (mean [SD] age, 14.2 [2.8] years; 7849 [48.5%] female and 8333 [51.5%] male), 11 718 had valid BP data with 3 repeated readings. the prevalence of high BP was 35.1% (95% CI, 31.5%-38.9%) in children aged 10 to 12 years and 25.1% (95% CI, 22.5%-28.0%) in children 13 years or older. Overweight and obesity were associated with a higher risk of high BP in both younger (prevalence ratio, 1.17; 95% CI, 1.04-1.34) and older children (prevalence ratio, 1.33; 95% CI, 1.18-1.49). The prevalence of high BP in younger children with stunting was high at 40.1% (95% CI, 31.9%-48.9%) and was 21.9% (95% CI, 18.2%-26.1%) among older children with stunting. In both age groups, high BP coexisted with other cardiovascular disease risk factors, such that adolescents with high fasting blood glucose, high hemoglobin A1c, high triglyceride, and high low-density lipoprotein cholesterol levels had a higher risk of high BP.
Conclusions and relevance:
In this cross-sectional study, the prevalence of high BP, along with cardiovascular risk factors, was substantial in Indian adolescents. There is a need to screen and identify adolescents who have high BP and initiate interventions to control the burden of hypertension and its consequences in India.
... It is a potential public health issue that [5,6] is emerging in the developing countries This is dreaded to be a major socioeconomic and public health burden that will [5,6] be faced by these countries in the near future It is increasingly being observed with the changing lifestyle of families with increased purchasing power, increasing hours of inactivity due to television, video games, and computers, which are replacing outdoor games and other social [7] activities The prevalence is higher in the urban than in the rural areas. Various studies done in India indicate a rising trend in the prevalence of overweight and obesity in children [8][9][10][11][12][13][14][15][16] and adolescents . The magnitude of overweight ranges from 9% to 27.5% and obesity ranges from 1% to 12.9% [17][18] among Indian children .This may have major implications [19,20] disease in early adulthood . ...
Background: The World Health Organization has declared overweight as one of the top ten health risks in the world. The magnitude of overweight and obesity ranges from 9% to 27.5% and 1% to 12.9%, respectively among Indian children. Objective: This study was done to estimate over-nutrition among school students and its’ predictors. Methodology: A facility based cross-sectional study was conducted among 151 students of mid adolescent age studying in class VII - IX during July - September, 2017 in Kolkata. Informed consent was obtained from the school authority and parents. A structured questionnaire was used to collect data on various characteristics. Scoring for unhealthy food habit was done. Over-nutrition was determined by comparing BMI with WHO age-gender specific chart for children aged 5-19 years. Analysis was done using SPSS (v 16). Results: A total of 33.1% students falls in over-nutrition category. On bivariate logistic regression, factors significantly associated were maternal education [OR 2.36, 95% CI (1.1-5.1)], status of physical activity [2.95, 95% CI(1.6-5.9)], frequency of eating out [OR 3.42, 95% CI (2.3-5.1)], skipping breakfast[OR 1.4, 95% CI (1.2-1.6)], screen time [OR 5.4 95% CI (2.6-11.8)] and hours spent sitting idle [OR 1.37, 95% CI (1.2-1.6)]. On multivarible analysis, frequency of eating out [AOR 5.1, 95% CI (2.46-10.4)], skipping breakfast [AOR 1.75, 95% CI (1.28-2.4)] and screen time [AOR 0.14, 95% CI (0.04-0.5)] remained significantly associated. Conclusion: Over-nutrition is not very uncommon among school children pertaining to changing lifestyle. Health education and training should be given due importance at par with academics.
... Traditionally, blood pressures have been measured using a manual mercury sphygmomanometer, but in recent years the use of automated blood pressure machines such as the Dinamap and Omron have been the trend in most hospitals (Jones et al., 2003). However, many nurses question the accuracy and reliability of these machines when used in the clinical setting and still prefer the manual sphygmomanometer which is considered the 'gold standard' when used by a trained observer (Butani and Morgenstern, 2003;Mohan et al., 2004;Bagga et al., 2007). There is some evidence in the literature that digital monitors are reliable and accurate when compared with other devices, such as the aneroid or mercury devices (Butani and Morgenstern, 2003;Sigurdsson et al., 1996;Carney et al., 1999;O'Brien et al., 2001). ...
Of the three mainly used non-invasive modalities for the accurate measurement of subjects' systolic and diastolic blood pressure, the mercury sphygmomanometer is the most widely accepted and used. However due to concerns of toxicity in the usage and disposal of mercury, several countries have directed policies to minimize the use of mercury instruments. The digital sphygmomanometer is also widely used since it is relatively cheaper, non-toxic and does not require auscultation skills to obtain blood pressure readings. However the concern is the accuracy and validity in the values obtained for systolic and diastolic blood pressure using the digital/automated sphygmomanometer. This study is posed on the evaluation of the validity and accuracy in comparison between mercury sphygmomanometer and the digital sphygmomanometer. Fifty (50) subjects were selected using the simple random sampling techniques from among male and female above 18 years old that complied with all instructions and met the inclusion criteria for this study. The study samples used were recruited on notice and home visits by taking blood pressure measurement using left and right arm. Findings from this study implied that there is a significant difference in the systolic blood pressure values obtained using the manual sphygmomanometer and the digital sphygmomanometer in the left arm (p=0.005) and in the right arm also (p=0.000). There is no difference however in the diastolic blood pressure values obtained using the manual sphygmomanometer and the digital sphygmomanometer in the left arm (p=0.174) and in the right arm (p=0.226). Findings from this study also showed a non-significant inter-arm difference (IAD) between systolic blood pressure using manual sphygmomanometer (0.34±1.22) and using digital sphygmomanometer (0.35±1.28). Likewise there is a non-significant inter-arm difference (IAD) between diastolic pressure using manual sphygmomanometer (2.43±1.60) and using digital sphygmomanometer (2.07±1.27). Based on the findings of this study it was concluded that the digital sphygmomanometer is reliable in terms of measuring systolic blood pressure, but in measuring lower blood pressures care must be taken in the use of digital sphygmomanometers.
... [23] In another study on 2467 school children aged 11-17 years in Ludhiana, sustained HTN was more prevalent in urban than rural areas. [24] This difference is observed even between semi-urban and urban resided adolescents. [25] It seems disparities in lifestyle patterns between urban and rural residents play important role in differences in pre-HTN/HTN prevalence between them. ...
Background:
This study was performed to determine the association of Pre-hypertension/hypertension (pre-HTN/HTN) with leisure-time activities and morning exercise at school in a sample of Iranian adolescents.
Methods:
This secondary study has done using data of 1992 adolescents participated in of Isfahan Healthy Heart Program. The outcome variable was having/not having pre-hypertension/hypertension (pre-HTN/HTN). The students with Blood pressure (BP) between 90th to 95th percentiles were considered as positive pre-HTN and students with BP >95th percentile were considered as positive HTN. Students with pre-HTN or HTN were considered as positive pre-HTN/HTN. The asked leisure-time activities were categorized in three group including first (ping-pong, basketball, and volleyball), second (football, walking, and bicycling) and sedentary activities (watching TV, studying, and computer gaming), using factor analysis.
Results:
The prevalence of pre-HTN and HTN was 16.1% and 6.7%, respectively. Based on multiple logistic regression pre-HTN/HTN was associated just with sedentary activities and morning exercise at school. Odds Ratio (95% confidence interval) for sedentary activities and morning exercise at school was 1.51 (1.13-2.01) and 0.63 (0.44-0.89), respectively.
Conclusion:
We observed adolescents who engaged in morning exercise at school had lower prevalence of HTN while those who spent more times on sedentary activities were in higher risk for HTN. We suggest to permanent holding of morning exercise and educational programs on healthy lifestyle skills for adolescents by schools.
... Women usually are more aware of and are more active in managing and treating their blood pressure, which was consistent with a previous research on women's health-seeking behaviors 16 . The prevalence of hypertension was significantly lower in rural areas than that in urban areas, which was consistent with some relevant studies 17,18 . It was perhaps because that students from different residences had different eating habits and study pressure. ...
Hypertension is the leading single contributor to all-cause death and disability worldwide. However, there is scarce evidence on the prevalence and risk factors of hypertension for Chinese youth. This study aimed to investigate the prevalence of hypertension among Chinese college freshmen and to identify the influencing factors. We conducted a cross-sectional study of all freshmen from 2015 to 2017 at a university in Wuhan, China by physical examination and standard-structured questionnaire. The Pearson chi-square test was used to compare categorical variables. Forward stepwise logistic regression method was used in the multivariate analysis to identify independent predictors of hypertension in youth. A total of 12,849 participants were included, and the prevalence of hypertension of Chinese college freshmen was 4.3% (7.9% in men and 1.6% in women). Men had a higher risk of hypertension than women (odds ratio [OR]: 5.358, 95% confidence interval [CI]: 4.345–6.607, P < 0.001). Obese people were more likely to develop hypertension than those with normal body mass index (OR: 10.465, 95% CI: 8.448–12.964, P < 0.001). People with elevated resting heart rate (RHR) had a higher prevalence of hypertension (OR: 4.987, 95% CI: 3.641–6.832, P < 0.001). Staying up late (OR: 2.957, 95% CI: 2.482–3.523, P < 0.001), physical inactivity (OR: 4.973, 95% CI: 4.141–5.972, P < 0.001), living in urban district (OR: 1.864, 95% CI: 1.493–2.329, P < 0.001) and family history of cardiovascular diseases (CVDs) (OR: 2.685, 95% CI: 2.108–3.421, P < 0.001) were related to higher prevalence of hypertension in youth. Male, obesity, elevated RHR, physical inactivity and family history of CVDs were identified as important risk factors of hypertension in youth. These risk factors should be given more attention when designing and implementing the interventional programs.
... They found that incidence of hypertension was 6.6% and 2.2% among children of rural and urban areas, respectively. 5 Gupta et al estimated the prevalence of hypertension as 6.6% among 3861 school-going children aged between 5 to 15 years in northern India. 6 Sabapathy et al included school-children of Bangalore, south India, in their study and found that prevalence of prehypertension and hypertension was 2.7% and 3.2%, respectively. ...
Hypertension is a silent threat to the developing countries in recent times. The aim of this article was to determine the burden of prehypertension and hypertension among school-going children and the risk factors associated with those conditions. A cross-sectional study was conducted among school-going children (6–18 years) in seven schools of Burdwan, West Bengal, India, selected by stratified random sampling from March 2017 to August 2018. Anthropometric and blood pressure measurements were obtained along with sociodemographic parameters. Prehypertension and hypertension were defined as per American Pediatric Society's definition. Mean age of the study population was 11.3 ± 3.8 years (n = 604). Prevalence of prehypertension and hypertension was estimated to be 5% and 4.6%, respectively. Both prehypertension and hypertension were more common among children aged > 15 years (10.3% and 15.5%). In logistic regression, the independent determinants of hypertension were higher socioeconomic condition, increasing age, obesity, increased intake of junk food, parental hypertension, and obesity among first-degree relatives. Proper preventive measures are the need of the hour to tackle the emerging epidemic at its root. Periodic measurements of blood pressure at regular intervals are advisable at community levels to recognize high-risk children, control obesity, and prevent irreversible end organ damages.
... Life-style shifts such as reduced physical exercise, elevated ingestion of excess calories, high sodium and low potassium diets, use of caffeinated and alcoholic drinks, obesity, emotional distress, and sleep loss are also reasons attributing to the increased incidence of hypertension in adolescents. 6 In children, the secondary aetiology of hypertension is very much probable than in adult individuals with renal parenchymal pathology, the most common was renovascular disease. In the USA, clinical studies indicate a major secular surge in SBP and DBP due to obesity, adversly change in eating patterns, reduced physical activity and elevated stress are the reasons for high blood pressure. ...
Background: In developed countries, childhood hypertension is a proven indicator of adult hypertension and organ damage and is estimated to be great concern. This study was conducted to assess the occurrence of childhood hypertension in school going children attending pediatrics OPD.Methods: An observational study was performed at TMMC and RC among 500 school going children attending pediatrics OPD in TMMC and RC over a period of 1 year. Socio-demographic variables including age, gender, family history of hypertension, parental smoking habits were recorded in a proforma. Dietary habits including consumption of junk food, fruits and daily calorie intake was evaluated utilizing number of times diet intake questionnaire and 24 hour recall method. Height was measured by stadiometer with candidate posing in bare feet. Weight assessment was done with bare footed and candidate clad in light clothing with weighing instrument of electronic type rounded to nearest unit.Results: Elevated blood pressure and hypertension was reported among 9.4% and 6.8% of the subjects respectively. High blood pressure was significantly associated with presence of family history, stress and lack daily physical activity. Chances of elevated blood pressure and hypertension increase along with the increase in subject height, weight and BMI.Conclusions: Performing the BP measurements in routine consultations becomes essential for diagnosis and early intervention.
... [6] HTN is a multifactorial disease and several factors are involved in its incidence including age, sex, weight, height, body mass index (BMI), positive family history, stress, and dietary habits. [7] This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-Non Commercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. ...
Background:
Hypertension (HTN) among children is a major health issue with mounting prevalence rates. The aim of this research is to assess the prevalence of HTN and its associated risk factors among apparently healthy schoolchildren.
Methods:
We conducted a cross-sectional study of schoolchildren in the academic year 2015 from 38 public primary schools in central Thailand for the prevalence and risk factors of HTN. Apparently healthy children aged 6-12 years were included. Informed consents were obtained before participation. Hypertension was diagnosed as per the new reference cutoff levels recommended by the American Academy of Pediatrics.
Results:
A total of 3,870 children with a median age of 9.5 years were included in the final analysis. The prevalence of obesity, overweight, and thinness among children was 15.7%, 13.6% and 5.2%, respectively. The overall prevalence of hypertension in the study population was 26.2%. HTN was significantly more prevalent in boys than girls (summary odds ratio (OR) 1.16 [95% confidence interval (CI) = 1.01-1.34]). Overweight and obesity were among the associated risk factors of HTN in the enrolled children with (OR 2.44 [95% CI 1.98-3.00]) and (OR 7.99 [95% CI 6.58-9.70]), respectively. Obese children who had central obesity were at greater risk of hypertension (OR 9.16 [95% CI 7.45-11.27]).
Conclusions:
The prevalence of HTN among Thai children is markedly high. Obesity, overweight, and male gender are considerable risk factors of HTN in children. Routine blood pressure measurement and further studies are recommended to investigate the potential risks and to lessen the associated complications.
... For labelling a child as underweight, normal, overweight or obese, the frequencies of BMI cutoffs relative to the National Centre for Health Statistics (NCHS)/World Health Organization (WHO) reference data (CDC Charts) 11 were used. ...
... Overweight and obesity in children and adolescents has been found to be associated with a variety of co-morbidities like cardiovascular disease, diabetes and hypertension (Sorof et al., 2004;Paradis et al., 2004;Andersen et al., 2008;Moser et al., 2013). Numerous investigations have examined the association between blood pressure and body weight status in children and adolescents by using body mass index as a measure of overweight and obesity and the results have shown that higher BMI was associated with elevated systolic blood pressure and diastolic blood pressure (Mohan et al., 2004;Genovesi et al., 2005;Sánchez-Zamorano et al., 2009;Chorin et al., 2015). However, BMI has a limitation as an index of obesity among children and adolescents as it does not distinguish between muscle and fat accumulation and is unable to comment on fat distribution (Nevill et al., 2006;Heymsfield et al., 2009;Millar et al., 2015). ...
... A child was identified as obese when Body Mass Index was found to be ≥the ninety-fifth percentile with reference to age and gender. For labelling a child as underweight, normal, overweight or obese, the frequencies of BMI cut offs relative to the National Centre for Health Statistics (NCHS)/World Health Organization (WHO) reference data (CDC Charts) 14 were used. ...
Childhood obesity is an important predisposing factor for most non-communicable diseases. Irrespective of the age and gender, the prevalence rates of overweight and obesity has attained alarming levels not only in developed countries but also in developing countries among all socio-economic groups. The prevalence of overweight and obesity has reached alarming levels, affecting virtually both developed and developing countries of all socio-economic groups, irrespective of their age and gender. Hence, the present study was aimed to identify the anthropometric measurements of selected overweight and obese school-going adolescents from different schools from Madurai district Tamil Nadu, India. A total of 514 adolescents (312 Girls and 202 Boys) aged 13-18 years participated from government and private schools. Mean height, weight and BMI were calculated and compared with (National centre for Health Statistics) NCHS standard references. The mean height, weight and BMI were found to be increasing as the age increases of both genders. Body Mass Index of Girls (34.18 – 35.24)was found to be higher than boys (33.49 – 32.89) of the same age group. The School-going adolescents of both genders, in general, have short stature at all ages as compared to NCHS reference data. The prevalence of Overweight 95 (18.48%) and obese 315 (61.28%) was found to be higher in Nuclear families, but there was no statistical association between family type and BMI (X2 = 2.575, p > .05). A significant relationship was found between the Body Mass Index of the adolescents and Father’s Educational qualification (p=.00) and Mother’s Occupation (p=.008). Nutrition education can play an important part in reducing the incidence of overweight/obesity and its associated complications.Extensive trials with a healthy school environment as an intervention may pave the way for developing new strategies to reduce the overweight and obesity in school-going adolescents.
... The prevalence of systolic hypertension (SBP>140) was 7.84% and diastolic hypertension (DBP >90) 2.15% in a study conducted by A. K. Singh et al. 15 A study conducted among children from rural areas by Mohan et al showed a prevalence of 2.56%. 16 Patil and Garg reported in their study 17 that prevalence of hypertension among children aged 6-16 years was 3%. ...
... High blood pressure is a major risk factor for stroke, CHD, heart or kidney failure. 5 It is one of the leading cause of death and disability worldwide. Although it is a problem of adult, but the etiologic process and risk behaviour start early in life. ...
Background: Although Hypertension is a problem of adult, the
etiologic process and risk behaviour start early in life. The present
study was conducted to find out prevalence of hypertension
among school going children in the age group 10-19 years. And to
determine socio-demographic factors associated with hypertension
in adolescent school children.
Material and Methods: A cross –sectional study was done among
1008 school adolescents in Jaipur city, data was collected by predesigned
semi structured questionnaire and anthropometric
measurements was done along with taking blood pressure. Analysis
was done using MS Excel and statistical software Primer version
6.
Results: A total of 1008 students studied having mean age 14.26
years and M:F ratio was 1.24. Prevalence of hypertension was
found 15.87%. Although hypertension was found more in male,
among age group of 17-19 years (18.72 %), Hindu, SC category and
students of among class I high socio-economic status families than
their counterparts, but it was found not significant except for cast.
Conclusion: Prevalence of hypertension among school going adolescent
was found 15.87%. It was found to be associated with caste
only not with other studied variables like age, sex, religion, socio
economic status and family history of hypertension.
Keywords: Prevalence, Adolescent Hypertension, School going
adolescent
... In our study, cut of value for hypertension was taken as greater than & equal to 95 percentile as per the recommendations of fourth task force report on high blood pressure in children [8]. We found the prevalence of BP among children between 5 -14 years to be 7.2% (6.6% in Boys & 7.9% in girls) as compared to study done by Mohan B et al., [9] in Ludhiana (6.7 %) and a higher prevalence (11.9 %) in a study done by Chadha S L et al., [10] from Delhi in the same age group. ...
Background: A Systematic review & meta-analysis revealed that there is ‘Strong evidence for tracking of Blood pressure from childhood to adulthood i.e., the Children in the upper percentile of Blood Pressure levels are more likely to become hypertensive in adulthood. Objective: To study the prevalence of Pre-hypertension & Hypertension and the relationship of Blood Pressure with variables like age, sex, weight, height, body Mass Index (BMI), Socio economic status and Family history in Urban school children. Materials & Methods: The present Cross-sectional study conducted in urban school children, Hyderabad. Total 2500 children of 5-14 years age group were involved in the study group; children were selected in random sampling method. Results: The Prevalence of Hypertension among children between 5 – 14 yrs was 7.2% (6.6 % in Boys & 7.9% in girls). Pre-hypertension prevalence was found higher in boys (6.2%) compared to girls (3%). Multiple Regression Analysis showed Positive and significant correlation of age, weight, height with each systemic blood pressure and diastolic blood pressure (P value <0.001). Conclusion: Regular Blood pressure measurement of children is mandatory for early detection of Pre-hypertension & hypertension.
... Of the 11.63% overweight children, 15% were hypertensive; whereas 43% of the obese children were hypertensive. 25 In the study by Patel et al 25% of the obese were hypertensive. 21 Thus, the increasing prevalence of overweight and obesity also has an adverse influence on hypertension. ...
Background: Hypertension is a prominent health disorder that leads to 12.8% of deaths worldwide. Although predominantly considered a disorder of the adults, the roots of hypertension start from childhood. In the past children usually suffered from secondary hypertension. However, now with increased incidence of obesity, reduced physical activity, unhealthy dietary habits, use of tobacco and alcohol among adolescents there is now an increased prevalence of primary hypertension in this age group. The present study was conducted with the objective of assessing the prevalence of hypertension and its modifiable risk factors in high school children.Methods: The study was conducted among high school students aged 13 to 16 years in urban Bangalore. A self-administered questionnaire was used to assess the lifestyle. Age, sex, height, weight and resting blood pressure were recorded. Odds ratio, Chi square test and logistic regression were used in the analysis.Results: There were 550 students who participated in the study, 300 (54.54%) were males and 250 (45.45%) were females. The prevalence of prehypertension was 21.6% and hypertension was 8.9%. Logistic regression revealed that overweight, obesity, high salt intake, tobacco use, and stress were significantly associated with elevated blood pressure.Conclusions: There is a rise in the prevalence of hypertension among high school students. Changes in lifestyle seem to influence the development of hypertension in this age group. Behaviour change communication should be used to reduce the modifiable risk factors and promote healthy lifestyle among adolescents.
... A similar nutritional transition is underway in India as well. The prevalence of obesity among children in the present study was higher than that reported by Mohan et al., [12] in Ludhiana, but lower than that reported by Sharma and Hegde in Mangalore. [13] This finding may be due to differences in sampling techniques or in lifestyle and cultural practices between different regions of India. ...
... [9] In another survey, Mohan et al. showed that hypertension was more common in boys not only in urban but also in rural area of Ludhiana, India. [16] A study by Buch et al. demonstrated slight increase in the prevalence of hypertension in boys aged older than 13 years compared to girls. [17] However, the gender effect has not been supported by all similar studies. ...
Hypertension is one of the most common diseases worldwide. For many decades, it was considered as a problem related to adult population; however, its incidence in children has also been increased in recent years. Although secondary causes of hypertension are more common in children, few studies have been published focusing on the growing epidemic rate of essential hypertension in children and adolescents. Considering the importance of essential hypertension and its cardiovascular consequences, we review briefly its epidemiology and risk factors in children.
... [24] Rural-urban differences in prevalence of obesity in India have been described by others and similar to our study, higher prevalence of obesity has been found in urban areas. [25,26] Higher prevalence of diabetes in urban population as compared to rural population also suggests higher blood glucose concentrations in urban populations. [27] We have found higher blood glucose in urban area (6.1% versus 4.7%) than in rural children. ...
Objective and aims:
Overweight/obese children are at risk of developing type 2 diabetes mellitus. Random glucose elevations provide early warning signs of glycemic dysregulation. To assess random blood glucose (RBG) concentrations and risk factors associated with prediabetes in children aged 3-18 years from six Indian regions.
Method:
Multicenter, cross sectional, observational school-based study; multi-stage stratified random sampling was carried out. Height and weight measured; body mass index (BMI) was computed. RBG measured using a glucometer. National sample survey was used for dietary patterns. Data were analyzed using SPSS 25.0 for Windows.
Setting:
Study centers were from Maharashtra, Gujarat, Chhattisgarh, Assam, Tamil Nadu and Punjab from 40 selected schools.
Participant:
Children aged 3-18 years were measured.
Results:
Data on 14339 subjects (7413 boys) were analyzed. Prevalence of obesity was 5.8% and overweight-10.6%. Overall, 1% had low (<3 mmol/L), 93.7% in reference range (3.9-7.2 mmol/L) and 5.3% had elevated RBG (>7.2 mmol/L). With increasing mean BMI, there was increase in RBG concentrations. Children from Tamil Nadu were more likely to have RBG outside reference range compared to other regions (P < 0.05). Assam and Punjab had highest prevalence of RBG and BMI within reference range. Energy intake partly explained regional variations. Multivariate analysis showed male gender, urban residency, age >10 yrs (girls) and 13 yrs (boys), and overweight or obesity were predictive of prediabetes.
Conclusion:
Increased prevalence of overweight, obesity and prediabetes in Indian children are a matter of concern. Regional differences suggest that strategies to prevent obesity and combat perturbations in blood sugar may have to be customized.
... Several studies to date have evaluated the relationship between tooth decay and obesity; however, results are sometimes contradictory [6][7][8][9]. Although some studies have reported that the prevalence of obesity in India is high, its relationship with dental caries appears to be scant [10,11]. Hence, this study assessed the correlation between age-specific body mass index (BMI) and dental caries in children aged three to 12 years. ...
Introduction:
Diet is a deeply ingrained element of a person's life. Children's dietary habits are a significant contributor to obesity and dental caries. Dental caries during childhood continues to be a significant public health concern, while childhood obesity is increasingly being cited as a major public health problem. This study aimed to assess the correlation between body mass index (BMI) and dental caries in children aged three to 12 years who attended both government and private schools in Chennai, Tamil Nadu, India.
Materials and methods:
We conducted a cross-sectional review of 2200 children aged three to 12 years with clinically recorded dental caries. The World Health Organization diagnostic criteria for BMI percentile was used to evaluate and record dental caries clinically. The Mann-Whitney and the Kruskal-Wallis tests were used for univariate comparisons.
Results:
Mean values between the overweight category and underweight category revealed no significant differences.
Conclusion:
We found no association between BMI-for-age and dental caries in children in both primary and mixed dentition. This relationship should be investigated further by longitudinal studies.
... Similar findings were seen by Mohan et al in school going children of Ludhiana, Punjab found that prevalence of sustained hypertension was 6.69% in urban and in rural area it was 2.56%. 11 Beevi et al in a study done in students of Government higher secondary school, Kilimanoor, Trivandrum district observed that prevalence of hypertension was 4.2%, all were males. 12 24.4% (30.8% in males and 18.2% in females) were found to be pre hypertensive. ...
Background: Adolescence is an intermediary phase from childhood to adulthood and is a very delicate phase of life. WHO has defined Adolescence as the period between 10-19 years of life. Among adolescents, girls constitute a more vulnerable group, particularly in developing countries, where they are traditionally married at an early age and are exposed to greater risk of reproductive morbidity and mortality. Nutritional deficiency disorders (stunting, wasting), menstrual disorders, mental health problems etc. appear as serious problem during this stage. The study was done with objective to assess the morbidity pattern in school going adolescent girls in Urban and Rural Prayagraj.Methods: A school based cross-sectional study was carried out in Prayagraj district. Study participants were 800 adolescent girls, 400 urban and 400 rural of age groups 10–19 years studying in class 6th to 12th. The data was collected by using predesigned, pretested, semi structured questionnaire and analyzed by using SPSS 21.0 version.Results: It was observed that most prevalent morbidity in rural and urban school going adolescent girls were dysmenorrhoea 381 (47.6%), pallor 296 (37%), psychological problems 325 (40.6%) and ocular diseases 191 (23.8%). Other morbidities were hypertension, dental problems, overweight/obesity, skin diseases, ear diseases, respiratory diseases, gastrointestinal diseases and injury.Conclusions: Out of 800 study participants, 275 adolescent girls were having morbidity. Significant difference in proportion of morbidities was found among rural and urban adolescent girls with ear diseases, eye diseases, pallor, dysmenorrhoea, overweight/obesity and hypertension.
... Epidemiological data shows that prevalence rates are increasing both in industrialized and developing countries especially in the adolescent population due to socioeconomic development leading to change in lifestyle. 2,3 According to WHO, one billion people are overweight and 300 million are obese worldwide. 4 According to the database of Overseas Development Institute (ODI), the situation in our country is quite alarming with one in three of the total 1.46 billion overweight or obese adults worldwide being an Indian. ...
Introduction: Heart Rate Variability is a common non-invasive technique with significant diagnostic, clinical and research application. Obesity is seen to be associated with autonomic dysfunction with increased sympathetic activity and decreased parasympathetic activity in young people predisposing them to increased cardiovascular mortality and morbidity. The aim of our study was to see how obesity effects cardiac autonomic activity in normal weight and obese individuals. Materials and Methods: The study was conducted on 60 young individuals between 18-25 years divided into two groups of 30 each based on their BMI: Group I-Normal weight group with BMI-18-22.9 Kg/ m 2 and Group II-Obese subjects with BMI ≥ 25 Kg/m 2. HRV was done in both the groups and was analyzed for time domain and frequency domain parameters. The data was analyzed by using students 't test' and Chi-square test. Correlation was done between various anthropometric measures and HRV using Pearson's correlation coefficient. Results: With the exception of height and neck circumference, all the anthropometric parameters were significantly higher in Group II compared to Group I While analyzing HRV for frequency domain parameters, LF (nu) and LF/HF were significantly lower in Group I compare to Group II. Time domain parameters of SDNN, RMSSD and pNN50 were significantly higher in Group 1. Conclusion: Our study showed a statistically significant reduction in parasympathetic activity and an increase in sympathetic activity in the obese compared to controls.
... Forty years of follow-up by the United States National Survey in a population of American African, European, and Mexican American ancestry of (8-17 years of age at baseline) reported that the mean increase in age-adjusted BP between 1988 and 2002 was greater for diastolic (~8 mmHg) than for systolic BP (~1 mmHg), and that the diastolic BP increase during this period was greater for lean (~9 mmHg) than for those at risk of overweight (~7 mmHg) and overweight (~5 mmHg) schoolchildren, suggesting some familial heritability in these values (Din-Dzietham et al., 2007). Thus, the prevalence of hypertension is increasing in urban areas in younger age groups, implicating environmental factors related to their sedentary lifestyle, altered eating habits, increased fat content in the diet and lack of physical activity ( Mohan et al., 2004). ...
... In this study, 25.3% of studied subjects were overweight or obese, and the ANOVA statistical test showed a statistical relationship between diastolic and systolic blood pressure with BMI (P <0.001), so that BMI increased with an increase in systolic and diastolic blood pressure, and the highest average blood pressure in adolescents with BMI was 95%. The relationship between blood pressure and BMI was expressed in several studies (28)(29)(30)(31)(32). Blood pressure in overweight and obese adolescents may be due to increased cardiac output, physical inactivity, high sodium intake, and alteration in recep-tors for various presser substances (27). ...
Objective (s): Recent increases in pediatric abdominal obesity suggest that children and adolescents should be assessed
anthropometrically as a step toward managing their long-term cardiovascular risk status. This study was conducted to
investigate the relationship between waist-to-height ratio and blood pressure in adolescent girls in Kashan, Iran.
Methods: This was a cross-sectional study. A sample of 1046 girls aged 11-19 years participated in the study and their height,
waist circumference, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured. Waist-to-height ratio
was calculated by dividing the waist to height. Abdominal obesity was defined WHtR > 0.5. Blood pressure in all girls who
had high blood pressure in the first visit, again was measured in second visit and if their blood pressure was high in the second
visit, again their blood pressure was measured in other visit (third time) and the average of the three blood pressure was
considered as their established blood pressure. Hypertension and prehypertension was defined according to percentiles of agesex
and height presented by the fourth report on the diagnosis, evaluation and treatment of hypertension of children and
adolescents. The findings were analyzed using descriptive and analytical statistics by of spss16 software.
Results: The prevalence of prehypertension and hypertension were 6.8% and 7.3% respectively and 24.6 percent of
participants had waist-to-height ratio greater than 0.5. ANOVA test showed positive relation between the mean of systolicdiastolic
blood pressure and waist-to-height ratio (p <0.0001), so that with increasing waist-to-height ratio, mean of systolic
and diastolic blood pressure increases.
Conclusion: The results of study showed that there was relationship between the mean of systolic and diastolic blood pressure
and waist-to-height ratio among adolescents and abdominal obesity was associated with increasing risk of hypertension
... Blood pressures of school going children increase with the age; which falls in accordance [5], hypertension in children and adolescents' states that 48% of the population had elevated systolic BP whereas 41% had elevated diastolic BP [6,7]. ...
Introduction: School children majorly face stress due to the pressure and expectations from their parents besides academics, athletics, etc. It is known that depression, stress increases blood pressure. Such wide variations in blood pressure at such a young age can increase the incidence of cerebrovascular accidents, ischemic heart diseases, renal failure and preterm death in the adulthood of such children. This survey will guide the parents and teachers to the various problems student face and how can they help the student cope with it. Method: The blood pressure of each student was taken three times to reduce them to minimise the possibility of errors and the blood pressures of all the students were compared according to their age (13-16 years) and the schooling type (boarders and day scholars). Results: On comparing the prehypertensive stage, the numbers of pre-hypertensives are found to be greater in the age group of 15 years in both day scholars and boarders i.e. 14% and 8% respectively. The on comparing the schooling type the day scholars have a greater number of prehypertensive i.e. 25% than boarders which is 17%. Though pre-hypertensives are higher in the age group of 15 years, but the numbers of hypertensives are more in 14 years of age which is 7% (6% in hypertension stage I and 1% in hypertension stage II) in day scholars and 4% (3% in hypertension stage I and 1% in hypertension stage II) in boarders. In schooling type, a similar trend as that of prehypertension is seen i.e. in day scholars 14% students are in hypertension stage I and 3% students are in hypertension stage II making a total of 17% of hypertensive in day scholars. Similarly, in boarders there are 6% in hypertension stage I and 1% in hypertension stage II making 7% hypertensive in boarders, thereby showing a higher percentage of hypertensive in day scholars. Conclusion: The study revealed Percentage of students in hypertension stage I and hypertension stage II were found more in day scholars (14% HT STAGE I and 3% HT STAGE II) than boarders (6%HT STAGE I and 1% HT STAGE II) respectively. Thus, it can be very well concluded that 17% of day school children and 7% boarders were found to be in hypertensive. Keywords: Variations in blood pressures, Day school; Boarding school Children; Western Maharashtra.
... 1 obesity in children and adolescents is gradually becoming a major public health problem in India. 2 In children BMI changes substantially with age, rising steeply with infancy, falling during preschool years, then rising during adolescence, and early adulthood. 3 The prevalence of hypertension in children is1-3%. ...
... -19 Studies from India have also shown similar findings. 14,[22][23][24] ...
Background: India is undergoing a rapid epidemiological transition with increased urbanization and socio-economic development which has resulted in a dramatic change in lifestyle, consisting of physical inactivity, diet rich in fat, sugar and salt coupled with a high level of mental stress. Obesity is one of the most common diseases worldwide and the prevalence in school aged children appears to be increasing. Thus, the present study was planned to establish an association between body mass index (BMI) with hypertension among 10-16 years children.Methods: Present longitudinal study was conducted on 350 children in private schools of District Kanpur and children 12-16yrs of age have included in the study. BMI for age charts was used to assess the obesity and blood pressure was measured by sphygmomanometer and Blood pressure values were compared to the values given by the update of 1987 task force report of the National high blood pressure Education Programme Co-ordinating Committee and children who were found prehypertensive or hypertensive were followed up after 4 weeks duration.Results: In present study the prevalence of overweight and obesity was found 4%,2% respectively. Prevalence of Pre-hypertension and hypertension was found 1.14%, 2.57% respectively and pre-hypertension and hypertension were found more in overweight and obese participants.Conclusions: Prevalence of pre-hypertension and hypertension is more among overweight and obese children. Overweight and obesity are not only risk factor for hypertension but also other diseases, so health education should regularly give about the obesity and its deleterious effects in later part of life.
... Adiposity rebound describes the inflection point between declines body mass index (BMI) and an increasing BMI that occurs between age 5 and 7 years Bray (2008). Association between obesity parameters and hypertension in children has been reported in several studies among a variety of ethnic and racial groups, with almost all studies finding higher blood pressures and higher prevalence of hypertension in obese and overweight compared with normal weight children ( Verma et al. 1994, Freedman et al. 1999and Sorof et al., 2002and Mohan et al. 2004). ...
The present study was carried out in 770 urban healthy school going boys of 5 to 10 years of age from middle socioeconomic class Bengali families by race. This study determined the association between anthropometric obesity parameters (i.e. body mass index, waist to hip ratio, waist to thigh ratio and body fat percentage) and cardio-respiratory fitness (PFI) and also were compared the selected physiological parameters (i.e. resting blood pressure, pulse rate and respiratory rate) among three body weight categories of boys. Boys were classified on the basis of BMI-age-boys-Z-scores into normal weight, overweight and obese. All the selected anthropometric obesity parameters and physiological parameters significantly varied (p<0.001, p<0.05) among three body weight categories. The lowest 5th to highest 95th percentiles values of PFI were lower in obese boys than those in normal weight and overweight boys. Obesity parameters were found to have significant negative correlation (p< 0.001) with PFI. Multiple regressions analysis demonstrated that there was highly significant (p< 0.001) and negative association of WHR with PFI when height, BMI, body fat% and WTR were constant. PFI scores and obesity indices are negatively associated. The results from this study indicate that central obesity marker (i.e. WHR) may be responsible for lower levels of PFI in overweight and obese boys. Thus, it is suggested to promote overweight and obese boys to decrease their body fat for increased cardiorespiratory efficiency.
... Mohan et al observed that, overweight population was significantly higher in urban area. 24 ...
Background: Childhood obesity and hypertension are on the rise and limited data are available regarding the profile of childhood obesity and hypertension from India. We studied the prevalence of childhood obesity and hypertension in a representative sample of school children to find out the relationship between obesity and hypertension in study population.Methods: This prospective, cross-sectional, observational study was conducted in Department of Pediatrics, Shri Vasantrao Naik Government Medical College, Yavatmal, Maharashtra, India and data were collected from urban and rural primary schools of Yavatmal from 1489 children between ages 6-12years, selected randomly. Anthropometric measurements were taken to calculate BMI and blood pressure was taken. Data was analyzed using CDC guidelines and statistically using contingency coefficient. Overweight and obesity were defined by body mass index for gender and age. Gender, age and height were considered for determining hypertension. The hypertensive children were followed up at 3 monthly intervals, 3 times, to look for persistent hypertension.Results: Amongst the 1489 children, prevalence of hypertension was 4.49% and that of pre-hypertension was 1.47% and that of overweight was 1.74% and obese was 0.87%. In girls and boys both, increasing BMI was associated significantly (p<0.0001) with average SBP and average DBP in both pre-hypertension and hypertension groups in rural and urban areas. A higher prevalence of pre-hypertension and hypertension seen in the present study group compared to similar studies in the state. Children with higher BMI were associated with pre-hypertension or hypertension.Conclusions: Prevalence of sustained hypertension overweight and obesity is on rise in children in this part of world. Possible related factors for this current trend may be the increasing sedentary life style, altered eating habits, and increased fat content of diet. The result suggests the need for more public awareness and prevention programs for childhood obesity and hypertension.
Introduction- The global prevalence of overweight and obesity in children and adolescents has increased substantially over the past several decades. Accumulating evidence suggests that Hs-CRP, which is also found within macrophages of atheromatous plaques. However, there is no much data available that guarantee its utility as a marker of cardiovascular risk in obese children and adolescents. Hence, the present study was taken up to assess the metabolic abnormalities and its association with hsCRP in obese children and adolescents. Methodology-Present cross sectional study was conducted on 100participants attending the tertiary care hospital of District Kanpur and 5ml fasting sample had been collected after overnight fasting and data was entered in Microsoft excel and analysed in SPSS 15.0 using ANOVAand unpaired student t test.Result- among cases group there were 4 participants among the age group of 4-8yrs,10 in the age group of 9-13yrs,23 in the age group of >13yrs while in control group there were 3 participants ampong 4-8yrs of age and 28 in 9-13 yrs ,32 participants among the age of >13yrs. On applying independent sample T-test, we could not established correlation between age and Hs-CRP (p value >0.05).Conclusion- obese children and adolescents have signicantly increased hsCRP compared with a normal weight group. Early intervention and prevention of obesity in children and adolescents decreases cardiovascular disease in later life
Introduction: Hypertension (HT) has its origin in childhood and
adolescent period but it goes undetected due to absence of
sign and symptoms, unless specifically looked for during this
period. It has been seen that one with raised blood pressure
level in this period will also have raised Blood Pressure (BP)
level in their adulthood and elderly period.
Aim: The present study was conducted to estimate the
prevalence of HT and its risk factor among apparently healthy
school going adolescents of Patna district.
Materials and Methods: A cross-sectional study among 2913
school going adolescents of eighth to 10th standard was conducted from April 2014 to August 2015 by adopting a two stage
cluster sampling technique. The questions pertaining to risk
behavior in relation to cardiovascular diseases from WHO’s Global
School based Student Health Survey were used for this study.
Results: The mean systolic and diastolic blood pressure of
study population was 107.4 mm of Hg (95% C.I. 106.93-107.77)
and 67.4 mm of Hg (95% C.I. 67.26-67.54), respectively.
Prevalence of pre-HT and HT was 10.9% and 4.6% in school
going adolescents while prevalence of overweight/obesity was
1.5%. Both systolic and diastolic blood pressures had positive
and significant correlation with age, height and body mass
index. The proportion of children who had ever taken tobacco
was 5.3%, cigarette smoking 4.3%, alcohol consumption 2.1%,
and excess salt intake 22.3%. Only 49.1% children were doing
physical activity at least one hour a day in past seven days for
maintenance of good health.
Conclusion: The present study recommends that regular
screening of blood pressure level must be initiated in adolescents
so that remedial measure can be initiated as early as possible.
Background
Despite the well-known short-term and long-term ill effects of elevated blood pressure in children and adolescents, pooled data on its burden among Indian adolescents have not yet been synthesized.
Objectives
We did a systematic review with meta-analysis to calculate the pooled prevalence of hypertension among adolescents (10–19 years) in India.
Methods
We searched PubMed, Embase, Cochrane library, Google Scholar and IndMed, and included cross-sectional studies reporting data on hypertension prevalence among 10 to19 years old and published in English language from their inception till 1st March 2020. Modified New castle Ottawa scale was used to assess risk of bias based on research design, recruitment strategy, response rate and reliability of outcome determination. A random effects model was used to estimate pooled prevalence, and heterogeneity was assessed using Cochrane’s Q statistic test of heterogeneity and I2 statistic. To explore the heterogeneity, we did a meta-regression, and sub-group analyses based on region, study setting and number of blood pressure readings.
Results
Out of 25 studies (pooled sample of 27,682 participants), six studies were of high, eighteen of moderate, and one was of low quality. The prevalence of hypertension across studies ranged from 2% to 20.5%, with a pooled estimate of 7.6% (95% CI: 6.1 to 9.1%), I2 = 96.6% (p-value <0.001). Sub-group analysis restricted only to the western India demonstrated a smaller heterogeneity (I2 = 18.3%). In univariate model of meta-regression, diagnostic criteria was significantly associated with pooled prevalence (-4.33, 95%CI: -7.532, -1.134)
Conclusion
The pooled prevalence of hypertension among adolescent in India is 7.6% with substantial heterogeneity between the studies. To tackle the high prevalence of hypertension among adolescents, early detection by screening under school health programme and opportunistic screening at Paediatric OPD should be implemented by Policy makers.
Increasing trend of hypertension and overweight have become a global health problem among youngsters. Over weight is strongly related to high blood pressure and the consequences of the increasing prevalence of overweight will be enormous in the future. Students in nursing profession are adolescents and they may have adjustment problems with new surroundings such as hostel, hospital and new curriculum. The stress experienced may predispose them to have increased blood pressure. A Cross sectional, correlational survey was conductedon blood pressure, stress and body mass index (BMI) among 200 BSc. Nursing Students in a selected college of nursing in Udupi District. The objectives of the study were to determine the blood pressure (BP), body mass index (BMI) and stress level of BSc nursing students, to compare the BP, BMI and stress of various batches of BSc nursing students and to determine the relationship among Blood pressure, BMI and stress. It is observed that 45% of the subjects were in pre hypertensive stage, and 3% in hypertension stage. Majority of the subjects had normal BMI. Moderate stress was experienced by 95.5% of the subjects. Study found a weak but positive correlation between BMI and BP and negative correlation with stress. A significant difference was found in mean stress score among four batches of students. There was no significant difference in BMI and BP of four batches of students. As nursing students experience stress, adequate support structures for clinical areas, preceptorshipprogrammes and the availability of student counselling services may be helpful to cope with the stress experienced.
Complementary and Integrative Medicine emphasizes a holistic approach to prevent and treat physical and mental illness. Coronary Heart Disease (CHD) and Type 2 Diabetes Mellitus are lifestyle related diseases. These are leading cause of morbidity and mortality around the world. A special attention is required to treat CHD patients with diabetes mellitus. CHD patients with diabetes have a number of adverse clinical and metabolic features such as severe angina, abnormal endothelial function with the reduction of coronary flow, multi-vessel involvement, and high incidence of left main coronary artery blockage, poor collaterals, and low ejection fraction, which contributes to poor prognosis. Clinical outcomes of coronary angioplasty and coronary bypass grafting (CABG) is also poor in diabetic CHD patients. CHD patients treated with PTCA and CABG procedures have the higher hospitalization rate with major complications, higher restenosis and revascularization chances. Thus to avoid invasive procedures and life-threatening consequences the complementary and integrative medicine approach is required for the management of angina, heart failure and diabetes mellitus. This manuscript will direct the complementary and integrative approaches with special reference to lifestyle and energy medicine in Rehabilitation of Coronary Heart Disease and Type 2 Diabetes Mellitus Patients.
Introduction
Hypertension is a global epidemic. Hypertension has become an increasingly important medical problem in children and adolescents. Evidence shows that hypertension begins in childhood and its associated risk factors like obesity, unhealthy eating habits also emerge in children of school going age.
Objectives
To study the prevalence of hypertension among school going adolescent boys in Najafgarh, Delhi and to find out the factors associated with hypertension among them.
Materials and methods
A cross-sectional study was planned in which a self-administered questionnaire was used to collect information from the study participants. A total of 600 adolescent boys of 9th to 12th classes from four different schools in Delhi, were included in the study over a period of 12 months. Blood pressure, height, weight and waist circumference were measured for all children. Data was analyzed using SPSS software version 21.0 and for qualitative data analysis a chi-square (χ ² ) test was used.
Results
The mean age of study subjects was 15.1 years. The majority of the study subjects, 372 (62%), were in the age group of 14–16 years. Among the study subjects, 44 (7.3%) had pre-hypertension and 26 (4.3%) had hypertension. Hypertension was significantly higher in those with a family history of hypertension and who were overweight/obese.
Conclusion
The prevalence of hypertension was significantly high among adolescents of Delhi. Obesity and family history of hypertension were identified as important risk factors prevalent in the study population.
Objective:
to evaluate anthropometric and demographic indicators associated with high blood pressure in children aged 6 to 10 years in urban and rural areas of Minas Gerais.
Method:
this is a cross-sectional study with 335 children. Anthropometric, demographic and blood pressure data were collected. The statistics analyzes were performed using the chi-square, t-student, Mann-Whitney and logistic regression tests, and the odds ratio was the association measure.
Results:
the prevalence of high blood pressure was significantly higher among rural children. In the urban area, the chance of high blood pressure was higher in children who had a high body mass index (2.97 [1.13-7.67]) and in the rural area, in those who had increased waist circumference (35.4 [3.0-406.2]) and the age range of 9-10 years (4.29 [1.46-12.6]).
Conclusion:
elevated body mass index and waist circumference were important anthropometric indicators for high blood pressure, as well as age in children living in rural area. The evaluation of body mass index and waist circumference, in addition to nutritional assessments, represents an important action for the screening of high blood pressure in children from different territorial contexts.
The present status of hypertension which has its emergence during adolescence is still unclear, but the magnitude of the problem should not be diminished by our limited understanding. The incidence of hypertension reported from a variety of regions in the world has been summed up by Loggie. The wide range from 0.6 to 20.5 per cent stresses again the work needed to define the problem more adequately.
Casual blood pressure was measured in 600 healthy school children in Kaduna, Nigeria. Of these children, 21 (3.5%) had blood pressure more than two standard deviations above the mean for age. There was no significant difference in the pattern of mean blood pressure in both sexes.
Blood pressure (BP) levels were recorded in 2223 male and 2205 female children and adolescents ranging in age from 7 to 18 years. In addition, 521 male adults (soldiers) ranging in age from 21 to 25 years were included in the study. Children and adolescents who participated in the survey were selected at random the Elementary and High Schools. The results of the study showed that a gradual increase occurred in the systolic, as well as in the diastolic component of blood pressure from 7 to 18 years of age. By contrast, there was no increase with age in the systolic and diastolic blood pressure in the young male adult subjects, who had BP measurements comparable to those observed in children. A child was characterized as hypertensive according to the criteria outlined by Master et al. Children with BP between the 90th and the 95th percentile were considered as suspect hypertensive, whereas those with BP exceeding the 95th percentile were considered definitely hypertensive. The overall incidence of hypertension in children in this survey was 3.1%.
The influence of family history of hypertension, myocardial-infarction and/or stroke on the blood pressure levels of 3,194 children in the age group 5-15 years was studied. Compared to children of normotensive parents, subjects coming from families with history of uncomplicated hypertension, complicated hypertension (hypertension plus myocardial infarction or stroke) and myocardial infarction or stroke without history of hypertension tended to have significantly higher levels of both systolic and diastolic pressures (p less than 0.001) in both the sexes in all age groups studied. Further, 15 (4.83%) of the children coming from families with positive history of one of the aforesaid morbid cardiovascular events had persistent hypertension (BP greater than mean +2 SD for age and sex). On the contrary only one (0.03%) of the 2,884 children belonging to normal parents had persistent hypertension. All the 16 children with sustained hypertension had only mild hypertension and were asymptomatic. Ten (62.5%) of them were obese (weight/height2 greater than 2.26). Baseline investigations failed to detect underlying cause to account for raised blood pressures in 9 of the 16 cases that could be investigated. These findings suggest that children of people with hypertension or other morbid cardiovascular events are more likely to have persistently elevated blood pressures than children from families without such a history.
A total of 3,861 school children in the age group 5-15 years were examined to establish the normative values for auscultatory blood pressure and to study the prevalence of sustained elevation of blood pressure in Indian children. Age-sex specific norms of systolic and diastolic blood pressure in the right upper limb were worked out. When the influence of age was minimised, the systolic and diastolic pressure still showed a positive correlation with height and weight. Two hundred and fifty five (6.60%) of the children screened were detected to have blood pressure level in excess of +2 SD of the mean for age and sex on first contact. The number declined to only 16 (0.41%) on re-evaluation 2 months after the initial contact. These 16 children continued to remain hypertensive during monthly follow up for 5 months. Family history of obesity, hypertension, or myocardial-infarction and/or stroke was met with in significantly higher (p less than 0.001) number of children with sustained hypertension as compared to normotensive students.
A total of 2073 school children between the age group of 5-14 years were examined to define the normal range of auscultatory blood pressure and prevalence of hypertension. An equal number of children in each age, sex and socio-economic group were studied. Mean figures for systolic and diastolic blood pressure with standard deviation and 95th percentile position for each age group were calculated. Systolic and diastolic blood pressure for both sexes had a direct correlation with age, weight and height. Overall prevalence of hypertension was found to be 2.93%.
Seventy-four asymptomatic children, 4 to 18 years of age, whose blood pressures repeatedly exceeded previously reported standards, were investigated for possible causes of hypertension. All but 2 were under 15 years of age when the presence of increased blood pressure was first documented. No apparent cause for hypertension was found in 69 of them. However, the prevalence of obesity and of parental hypertension was significantly higher in these children than in normotensive subjects. The systolic or diastolic pressures or both were still elevated in 65 per cent of 46 patients followed for 3 to 8 years after their hypertension was first documented. These observations raise the question of whether such hypertension in childhood may be a prelude to essential hypertension in later life.
Patients with essential hypertension are at an increased risk for sudden cardiac death. As is the case with other complications of hypertension, this increased risk reflects the interplay between a higher prevalence of coronary artery disease and the pathophysiologic consequences of left ventricular hypertrophy. The presence of coronary artery disease is the most important factor, but left ventricular hypertrophy also results in changes in the coronary circulation that predispose to myocardial ischemia, and is also associated with an increased frequency of ventricular arrhythmias. Hypertension itself is associated with changes in the autonomic nervous system that may predispose to sudden death. It is therefore likely that the mechanisms responsible for sudden death are multifactorial, but it is also clear that effective antihypertensive therapy will prevent or mitigate these predisposing factors and will reduce the incidence of this and other cardiac complications.
Distribution patterns of blood pressure were studied in a randomised sample of 10,215 school children (5,709 boys 4,506 girls) in the age group 5-14 years in Delhi. The mean values of systolic and diastolic blood pressure (SBP and DBP) increased with age in both sexes. The cut-off points for high blood pressure were based on average SBP and/or DBP values of 95th percentile or greater for each age. The values for SBP ranged from 70 mm Hg to 140 mm Hg and for DBP from 36 mm Hg to 100 mm Hg for the age group 5-9 years. In the age group 10-14 years, the values for SBP and DBP ranged from 72 mm Hg to 160 mm Hg and from 46 mm Hg to 120 mm Hg, respectively. The prevalence of hypertension (systolic, diastolic or both) was 11.9 percent in boys and 11.4 percent in girls, an insignificant difference. Anthropometric variables like height, weight and body mass index showed positive correlation with systolic as well as diastolic blood pressure but the waist-hip ratio showed negative correlation coefficient with blood pressure. Family history of hypertension in one or both the parents was present in 20.4 percent children with high blood pressure compared to 6.8 percent in normotensives. Family history or diabetes was also significantly higher in hypertensive children (5.4%) than in normotensives (3.1%).
THERE is considerable evidence that the incidence of hypertension is significantly greater among obese adults than among similar nonobese persons.1 , 2 Numerous studies have been published indicating that when weight reduction is brought about in such cases a fall in the elevated blood pressure frequently follows.3 4 5 6 7 8 9 10 11 12 13 Although this extensive list suggests a remarkable agreement among observers, at least two authors have expressed doubt that a decline in weight is responsible for a decline in the high blood pressure of obese subjects.14 , 15 For some years one of us (L.K.D.) has been interested in the relation of sodium to the hypertensive process in . . .
Obesity has been considered in terms of its two components: excessive bulkiness of the body or overweight and excessive fatness or adiposity.Reference was made to the main items of published evidence concerning a relationship between coronary heart disease (clinical and pathologic aspects) and obesity (bulk and fatness).The results were described of a search among men of different ages in Australia and New Guinea for factors related to body bulk or fatness which might be concerned in the pathogenesis of coronary disease. Weight divided by height squared was used as the index of body bulk and the sum of skinfolds at three sites as the measure of fatness. Bulk and fatness were closely related and increased with age in the Australians. The natives of New Guinea were lean, with normal bulk indexes which did not change with age; variations in bulk were attributable to variations in muscle, not fat. Excessive bulk, adiposity, hypercholesterolemia and hypertension were practically absent from the native population but were found often, increasingly with advancing age, in Australians.Neither the total serum cholesterol concentration nor two measures of blood coagulability showed any relation to bulk or fatness. Fibrinolytic activity decreased with increasing adiposity in Australians and increased with increasing bulk (musculature) in the natives. Blood pressure and the percentage of cholesterol carried in beta-lipoproteins increased with obesity in young Australians.Consideration of these findings, together with pertinent evidence from other reports, strongly supports the suspicion that adiposity is malevolent, but it is likely that physical indolence rather than obesity itself is to blame.
A study of the blood pressure in 1,417 schoolboys aged 11 to 15 years is presented. Mean, standard deviation, range and percentage distribution of systolic and diastolic blood pressure were determined, the correlation between systolic and diastolic blood pressure ascertained, and formulae established from the regression equations. The correlation of systolic blood pressure, weight, height and body surface area was analysed and formulae given for the determination of the normal individual blood pressure, using the regression equations. The study reveals (1) that there is a wide variation of systolic and diastolic blood pressure which becomes more marked once puberty starts. (2) Systolic and diastolic blood pressure 'spurts ' with the beginning of puberty, i.e. at the same time as the third period of acceleration of growth. (3) Of the 11.5-year-old boys 78.1%, and 70.5% of the 12.5-year-old boys have a systolic blood pressure between 90 and 119 mm., whereas three- quarters of the 13.5- to 15.5-year-old boys exhibit a systolic blood pressure between 100 and 129 mm. Of the 15.5-year-old boys, 62.3% have a systolic blood pressure between 110 and 139 mm. About three-quarters of the 11-, 12- and 13-year-old boys have a diastolic blood pressure between 50 and 69 mm. Hg, whereas 72.5 and 81.8% of the 14- and 15-year-old boys show a diastolic blood pressure within the range of 60-79 mm. Hg. There is a statistically significant correlation between systolic and diastolic blood pressure. To ascertain what might be considered the individual normal blood pressure the correlation between blood pressure and anthropometric measurements was determined. It is positive for weight, height and body surface area, being closer with weight and body area than with height. The association between blood pressure and growth is higher than that of blood pressure and age for the age groups under consideration. Generally each boy has the blood pressure of his physiological age. The correlation of blood pressure, weight and body surface area permits the prediction of the normal blood pressure for the individual from the respective regression equation, and formulae to this effect are presented.