Prevalence of elevated blood pressure and hypertension and its associated factors among children attending high schools in a rural panchayath of Kerala

Abstract

Abstract CONTEXT: Hypertension (HTN) in childhood and adolescence causes premature atherosclerosis and early cardiovascular disease. Although asymptomatic, they may have target organ damage. In 2017, the American Academy of Pediatrics updated the Clinical Practice Guideline for screening and managing high blood pressure (BP) in children and adolescents. However, no published studies from India have utilized this updated criterion for pediatric HTN. The coronavirus disease of 2019 (COVID-19) pandemic forced many children to spend long hours indoors, with increased exposure to digital devices and decreased physical activity. Hence, this study was done to assess the prevalence of HTN among children and to find associated risk factors. AIMS: This study aimed to determine the prevalence of elevated BP and HTN among children attending high schools of a rural panchayath in Kerala, to evaluate the anthropometric and epidemiological factors associated with elevated BP among them, and to find the prevalence of obesity among these children. SETTINGS AND DESIGN: This is a school-based cross-sectional study conducted among students attending high schools in Ambalappuzha North panchayat of Alappuzha, Kerala. MATERIALS AND METHODS: The study was conducted over 9 months from November 2022 to July 2023. Consent was requested from parents of all children (N = 847) studying in high schools. Children who provided assent and met the inclusion–exclusion criteria were enrolled (N = 576). Data were collected using a pre-validated semi-structured questionnaire. Children were interviewed about their lifestyle, including physical activity, sleep, diet, and exposure to smoking. Height and weight were recorded, and body mass index (BMI) was calculated. BP was measured using a digital oscillometric apparatus (OMRON HEM 7143T1A). STATISTICAL ANALYSIS USED: Data were analyzed using Statistical Package for the Social Sciences version 16 software. RESULTS: The study population comprised 345 boys and 231 girls. Elevated BP affected 12.3%, while stage I HTN affected 0.7% of the screened children. Additionally, 16% of the screened children were overweight, 8% were obese, and 7.5% were undernourished. The prevalence of abnormal BP (elevated BP + HTN) was 10.3% among children with normal BMI, 18.47% among overweight. and 26.08% among obese children. CONCLUSIONS: Elevated BP, HTN, obesity, and overweight are prevalent among adolescent children in Ambalappuzha North Panchayath, a rural coastal area. High BMI correlates with elevated BP and HTN and should be the focus of interventions.