Prevalence of high blood pressure among young rural adults in relation to height in childhood and adult body mass index.

OBJECTIVE

Evidence, mostly based on developed countries, indicates that disease risks may be associated with changes in growth processes rather than a one-point phenomenon. In view of the increasing prevalence of hypertension in India, there is a need to understand how patterns of growth during early childhood and adolescence influence blood pressure in adulthood, particularly among rural populations in India.

METHODS

The risk of hypertension was examined in 378 rural men older than 20 years who were measured for anthropometry during early childhood, adolescence, and as young adults in a community-based cohort study.

RESULTS

At the young age of 24 years, 33.9% of men had either high systolic blood pressure (≥130 mmHg) or high diastolic blood pressure (≥85 mmHg), even in absence of obesity. The growth of the subjects during childhood, in whom blood pressure developed later in young adulthood, was characterized by higher body mass index (BMI) throughout early childhood and adolescence as compared with those who had normal blood pressure. The prevalence of high blood pressure, especially diastolic, at this adult age was strongly associated with stunting at 3+ years of age (<-2 SD height of the World Health Organization standard), and risk increased (odds ratio, 12.21; 95% confidence interval, 2.93-50.90; p < 0.001) among those having high BMI (≥23 kg/m(2)) at adult age as compared with those who were not stunted in early life with a low BMI at adult age.

CONCLUSIONS

The primary prevention of the epidemic of high blood pressure in India may require measures to prevent children from being stunted in early childhood and also prevent them from being overweight at young adulthood.