A recent study conducted across primary and secondary schools in rural areas of four Indian states has revealed that about 23% of the children had high blood pressure (BP). The high prevalence of high BP in otherwise healthy schoolchildren turns the spotlight on the need for proper screening and management programmes.
A multi-institutional team led by doctors from All India Institutes of Medical Sciences (AIIMS), New Delhi screened over 14,000 children in the age group 5-15 years in Goa, Haryana, Gujarat and Manipur. Children with known medical complications were excluded from the study. Almost equal number of boys and girls were studied.
Of the 23% children with high BP, 13.6% exhibited systolic hypertension, 15.3% diastolic hypertension and 5.9% exhibited both.
Lifestyle changes
“Most of these elevated BP cases can be corrected with lifestyle modifications such as regular exercises, reduction in the intake of junk food,” says Dr. Anita Saxena, Professor from the Department of Cardiology at AIIMS and the corresponding author of the paper published in the European Journal of Preventive Cardiology .
The researchers found wide variation in high BP numbers depending on the location — at nearly 30%, Manipur had the highest prevalence, followed by Haryana (26.5%), Gujarat (13.6%) and Goa (about 10%).
According to the report, the prevalence was higher in the two states which have lower ambient temperatures over the year, while two with lower prevalence are closer to the ocean. “Higher humidity [in Gujarat and Goa] could have caused increased perspiration and hence salt and water loss from body,” the study says. Ethnic variations and genetic factors could have also played a role.
Unlike in the case of adults, blood pressure cutoffs in children below 15 years depend on age, gender and percentile height. “This makes the process cumbersome and difficult for doctors and health-care providers,” says Dr. Rajiv Narang, Professor at the Department of Cardiology, AIIMS and first author of the paper. “In an earlier study, we found that simple cut-offs of 120/80, 125/85 and 135/90 mmHg can be used to detect high blood pressure in children of ages 5, 10 and 15 years, respectively.”
High BP in childhood can lead to early onset of heart diseases in adulthood and so there is an urgent need for early monitoring.
Obesity-linked hypertension seen in many western countries is now been seen in children in developing countries.
More studies in the Indian context and also newer aspects of hypertension like prenatal exposure to maternal stress and effect of traffic-related air pollution need to be examined.
