Patel Ashish, Bharani Anil, Sharma Meenakshi, Bhagwat Anuradha, Ganguli Neepa, Chouhan Dharampal Singh
Department of Medicine, MGM Medical College, Indore, Madhya Pradesh, India.
Scientist 'F', Division of Noncommunicable Diseases, Indian Council of Medical Research, New Delhi, India.
Ann Pediatr Cardiol. 2019 May-Aug;12(2):90-96. doi: 10.4103/apc.APC_13_18.
Epidemiological transition with increasing burden of cardiovascular risk factors is evident not only in adults but also in children. The data on the prevalence of prehypertension and hypertension in children show large regional differences in India and such data are not available from Central India. We, therefore, conducted a large cross-sectional study in Indore to determine the distribution of blood pressure (BP) and the prevalence of hypertension and prehypertension among schoolchildren.
A total of 11,312 children (5305 girls, 6007 boys) aged 5-15 years, drawn from 80 government and private schools in equal proportion, were evaluated. Anthropometric measurements were obtained and BPs were measured using The Fourth Report on The Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents as reference standard. BP ≥90 to <95 percentile for given percentile of height was considered as prehypertension, whereas any BP ≥95 percentile was defined as hypertension. Multiple linear regression analysis was used to find out the determinants of hypertension in these children.
Prehypertension was detected in 6.9% and 6.5% and hypertension was found in 6.8% and 7.0% of boys and girls, respectively. Height and weight were found to be a significant predictor of systolic and diastolic BP among both boys and girls.
Our results show a high prevalence of prehypertension and hypertension in Indore schoolchildren with age and height being significant determinants. This highlights the need for routine BP measurements in children by pediatricians when they treat them for intercurrent illnesses or vaccinate them. It should also be mandatory as a part of school health checkup programs to detect childhood hypertension for further counseling and therapy.
心血管危险因素负担不断增加的流行病学转变不仅在成年人中明显,在儿童中也很明显。印度儿童高血压前期和高血压患病率的数据显示出很大的地区差异,而印度中部地区尚无此类数据。因此,我们在印多尔进行了一项大型横断面研究,以确定学龄儿童的血压分布以及高血压和高血压前期的患病率。
从80所政府和私立学校按相等比例抽取了11312名5至15岁的儿童(5305名女孩,6007名男孩)进行评估。获取人体测量数据,并使用《儿童和青少年高血压诊断、评估和治疗第四次报告》作为参考标准测量血压。给定身高百分位数的血压≥90至<95百分位数被视为高血压前期,而任何血压≥95百分位数则被定义为高血压。采用多元线性回归分析来找出这些儿童高血压的决定因素。
男孩和女孩中高血压前期的检出率分别为6.9%和6.5%,高血压的检出率分别为6.8%和7.0%。身高和体重被发现是男孩和女孩收缩压和舒张压的重要预测因素。
我们的结果显示,印多尔学龄儿童中高血压前期和高血压的患病率很高,年龄和身高是重要的决定因素。这突出了儿科医生在为儿童治疗并发疾病或接种疫苗时进行常规血压测量的必要性。作为学校健康检查计划的一部分,检测儿童高血压以便进行进一步咨询和治疗也应成为强制性要求。