Prevalence of hypertension in healthy school children in Pakistan and its relationship with body mass index, proteinuria and hematuria

Abstract

To determine the prevalence of high blood pressure (BP) in healthy school Pakistani children and its association with high body mass index (BMI), asymptomatic hematuria and proteinuria, we studied 661 public school children and measured their body weight, height and BP and urine dipstick for hematuria performed on a single occasion. Hypertension (BP >95 th centile) and pre-hypertension (BP >90 th centile) were defined based on the US normative BP tables. Over-weight and obesity were defined according to the World Health Organization (WHO) classification of BMI. The mean age of the children was 14 ± 1.3 years. The mean BMI was 18.5 ± 4.3 kg/m 2 . The majority (81.8%) of the children were found to be normotensive (BP <90 th centile). Pre-hypertension was observed in 15% and hypertension in 3% of the children. Overweight was observed in 7.7% and obesity in 1% of the children. The independent risk factors for hypertension and pre-hypertension were age of the child (RR 1.2 95% CI 1-1.4), gender (RR 2.0 for being female 95% CI 1-4.4), BMI >25 (RR for BMI b/w 25-30 = 2.6, RR for BMI >30 = 4.3), positive urine dipstick for proteinuria (RR = 2.3 95% CI 0.7-7.7) and positive urine dipstick for hematuria (RR 1.0 95% CI 0.2-8.3). Hypertension in children is strongly correlated with obesity, asymptomatic proteinuria and hematuria. Community based screening programs for children should include BP recording, BMI assessment and urine dipsticks analysis and approach high-risk groups for early detection and lifestyle modifications.

Elevated blood pressure and its associated risk factors among adolescents of a North Indian City - A cross-sectional study

“…support the association of obesity with high BP. [ 12 13 ] In obese children, activation of sympathetic nervous system shifts the arterial pressure control mechanism of diuresis and natriuresis to higher BP levels might be the possible reason illuminating the association. [ 14 ] More frequent junk food consumption seen in our study population tend to elevate their BP levels.…”

Prevalence of hypertension, obesity, hematuria and proteinuria amongst healthy adolescents living in Western Saudi Arabia

“…We found an alarmingly high prevalence of elevated BP levels in adolescents (17.2%), which happens to be much higher than previously reported from other Arab and Asian countries such as Iraq, Pakistan, and India. 17 - 19 A recent study from India from 2009 and 2010 reported the prevalence of hypertension as 5.62% in school adolescents. 18 Another study 19 from Pakistan reported the prevalence of hypertension to be 3%.…”

“…17 - 19 A recent study from India from 2009 and 2010 reported the prevalence of hypertension as 5.62% in school adolescents. 18 Another study 19 from Pakistan reported the prevalence of hypertension to be 3%. Western studies, 20 , 21 also reported a lower prevalence of hypertension in 2-5%.…”

“…However, the prevalence of prehypertension was lower in our study compared with previous reports. 19 - 21 The true prevalence of hypertension could be lower due to the fact that we did not follow all children, although all were given appointments to our pediatric services. We observed a significant correlation between BMI and high blood pressure levels, which is similar to figures demonstrated in previous studies.…”

Fast foods and physical inactivity are risk factors for obesity and hypertension among adolescent school children in east district of Sikkim, India

“…[ 8 21 24 25 27 30 31 ] The increased prevalence of prehypertension and hypertension among overweight and obese children compared to their nonoverweight counterparts is a significant cause for concern. [ 32 ] Overweight, as well as obesity, is positively correlated with less physical activity and higher socioeconomic group. [ 8 ] This is further enhanced by higher average fast food intakes and screen time.…”