Department of Pediatric Nephrology, St Johns Medical College and Hospital, St John's Medical College, Bengaluru, India.
Department of Biostatistics, St John's Medical College, Bengaluru, India.
JAMA Netw Open. 2022 Oct 3;5(10):e2239282. doi: 10.1001/jamanetworkopen.2022.39282.
High blood pressure (BP) in children and adolescents is becoming one of the most common health conditions worldwide and is much more widely prevalent than previously thought.
To estimate the prevalence of high BP in adolescents in India and identify associated factors.
DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study is a secondary analysis of data from the Comprehensive National Nutrition Survey (CNNS, 2016-2018), which used a multistage, stratified, probability proportion to size cluster sampling design to enroll a nationally representative sample of households and individuals aged 10 to 19 years across all states and union territories of India. Adolescents with acute or chronic illness, physical deformity, mental illness, or cognitive disability were excluded from the survey. Because BP was measured only in children between 10 and 19 years of age, only data from children within this age group were included for secondary analyses. Data analysis was performed from March 2021 to April 2022.
Anthropometry.
On the basis of the 2017 American Academy of Pediatrics guidelines, high BP was defined as stage 1 and 2 hypertension, with BP above the 95th percentile in children younger than 13 years and greater than 130/80 mm Hg in children 13 years or older. The association of age, sex, region, socioeconomic status, body mass index, fasting blood glucose, hemoglobin A1c, and lipid profile with high BP were examined using log binomial regression.
Among 16 182 eligible children aged 10 to 19 years (mean [SD] age, 14.2 [2.8] years; 7849 [48.5%] female and 8333 [51.5%] male), 11 718 had valid BP data with 3 repeated readings. the prevalence of high BP was 35.1% (95% CI, 31.5%-38.9%) in children aged 10 to 12 years and 25.1% (95% CI, 22.5%-28.0%) in children 13 years or older. Overweight and obesity were associated with a higher risk of high BP in both younger (prevalence ratio, 1.17; 95% CI, 1.04-1.34) and older children (prevalence ratio, 1.33; 95% CI, 1.18-1.49). The prevalence of high BP in younger children with stunting was high at 40.1% (95% CI, 31.9%-48.9%) and was 21.9% (95% CI, 18.2%-26.1%) among older children with stunting. In both age groups, high BP coexisted with other cardiovascular disease risk factors, such that adolescents with high fasting blood glucose, high hemoglobin A1c, high triglyceride, and high low-density lipoprotein cholesterol levels had a higher risk of high BP.
In this cross-sectional study, the prevalence of high BP, along with cardiovascular risk factors, was substantial in Indian adolescents. There is a need to screen and identify adolescents who have high BP and initiate interventions to control the burden of hypertension and its consequences in India.
儿童和青少年的高血压（BP）正成为全球最常见的健康问题之一，其流行程度远高于此前的认知。
评估印度青少年高血压的患病率，并确定相关因素。
设计、地点和参与者：这是一项横断面研究，对 2016-2018 年全面国家营养调查（CNNS）的数据进行二次分析，该调查采用多阶段、分层、概率比例大小聚类抽样设计，在印度所有邦和联邦属地招募了具有代表性的 10 至 19 岁的家庭和个人样本。患有急性或慢性疾病、身体畸形、精神疾病或认知障碍的青少年被排除在调查之外。由于仅在 10 至 19 岁的儿童中测量血压，因此仅对该年龄组内的数据进行二次分析。数据分析于 2021 年 3 月至 2022 年 4 月进行。
人体测量学。
根据 2017 年美国儿科学会指南，高血压定义为 1 期和 2 期高血压，在 13 岁以下儿童中，血压高于第 95 百分位，在 13 岁及以上儿童中，血压高于 130/80mmHg。使用对数二项式回归检查年龄、性别、地区、社会经济地位、体重指数、空腹血糖、糖化血红蛋白和血脂水平与高血压的关联。
在 16182 名符合条件的 10 至 19 岁青少年（平均[标准差]年龄 14.2[2.8]岁；女性 7849 名[48.5%]，男性 8333 名[51.5%]）中，有 11718 名有有效血压数据，有 3 次重复读数。在 10 至 12 岁的儿童中，高血压的患病率为 35.1%（95%CI，31.5%-38.9%），在 13 岁及以上的儿童中为 25.1%（95%CI，22.5%-28.0%）。超重和肥胖与较低年龄段（患病率比，1.17；95%CI，1.04-1.34）和较高年龄段（患病率比，1.33；95%CI，1.18-1.49）儿童高血压风险增加相关。身材矮小的较年轻儿童中高血压的患病率较高，为 40.1%（95%CI，31.9%-48.9%），而身材矮小的较年长儿童中高血压的患病率为 21.9%（95%CI，18.2%-26.1%）。在这两个年龄组中，高血压都与其他心血管疾病危险因素并存，例如空腹血糖高、糖化血红蛋白高、甘油三酯高和低密度脂蛋白胆固醇高的青少年高血压风险更高。
在这项横断面研究中，印度青少年高血压的患病率以及心血管风险因素都很高。需要对患有高血压的青少年进行筛查和识别，并采取干预措施来控制印度高血压的负担及其后果。
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