Prevalence and Risk Factors of Hypertension Among Children Attending Out Patient Department of a Tertiary Care Hospital in Karachi

Abstract

Introduction: The childhood obesity epidemic has caused the global prevalence of hypertension (HTN) in children to increase from 2% to 4%. However, there is limited data regarding this issue in Pakistan. Hence this cross-sectional study aims to document the prevalence of HTN and its risk factors among children visiting the out patient department (OPD) of a government hospital in Karachi, which is one of the largest cities in Pakistan. Methods: One thousand children aged between 4 and 12 years who visited the OPD in October 2019 were included. Blood pressures (BPs) for each child were measured manually and recorded. Their guardians were then interviewed to assess the risk factors present in each child. Data collected were analyzed using SPSS (Statistical Package for the Social Sciences). Results: Among all the children, those between 4 and 7 years of age had a higher prevalence of HTN (19.2%; 9.2% stage 1 and 10.0% stage 2) than children aged between 8 and 12 years (14.5%; 8.0% stage 1 and 6.5% stage 2). Obese children between the age of 4 and 7 years (OR = 3.11) were more likely to develop HTN. Moreover, children with a positive family history of HTN were 1.43 times more likely to have HTN and 1.32 times more likely to have pre-HTN. There was no significant association of gender, artificial feeding, low birth weight, and maternal smoking with HTN. Conclusion: The prevalence is particularly higher in children aged between 4 and 7 years (19.2%) and there is a strong association between high BMI (body mass index), family history of HTN, and high-fat diet intake with HTN in children. There was no significant variation of prevalence between both genders.

Frequency of Hypertension in Children Presenting at Combined Military Hospital Malir Cantt Karachi

“…Bilal et al, conducted a similar study in Karachi in 2019 in which hypertensive prevalence was 21.1% among males and 19.3% among female children, although this gender difference was not statistically significant considering hypertension prevalence. 16 Similar pattern was found in Zhai et al, study from China, where 20.2% of the male population and 16.3% of the female population were hypertensive. 17 Male gender and baseline masked hypertension were independent risk factors for developing sustained hypertension in preadolescents and adolescents.…”

How Strongly the Body Mass Index (BMI) Is Associated with Inter Arm Blood Pressure Difference

“…13 These findings were also supported by a study conducted in Karachi that showed a similar relation in children. 14 Indian study conducted at Amritsar also reported similar findings. 15 Significant IAD difference was observed in systolic and diastolic blood pressure of obese and nonobese subjects.…”

“…However, the point of concern is exactly how much alteration in blood pressure is existent. 14 Our study comprised 100 subjects, among them 46% were obese, and 54% were non-obese. Similar results were also found in a study done by Khan et al, who found 37% of the participants obese.…”

Cardiovascular Dysfunction in Children Exposed to Preeclampsia During Fetal Life

“…The prevalence in our unexposed group is similar to previous BP report in ''healthy'' Pakistani children. 23,24 A recent meta-analysis indicated that reductions in BP as small as 10 mm Hg in adults can cause a 20% reduction in stroke and 17% reduction in coronary artery disease, thus indicating the importance of early screening and aggressive management for an impact on CVD morbidity and mortality. 25 On subgroup analysis, children in the early-onset PE subgroup had a higher frequency of stage 1 HTN compared with healthy control subjects.…”