Parents, watch out. Your child may have high BP

This is one area India would not like to overtake the US in. A study has revealed that hypertension or high blood pressure (BP) among Indian adolescents is higher than their American counterparts.

About 2-5% of children in the US suffer from hypertension, while the figure for students in New Delhi schools and colleges is 6.4%, almost the same as what was discovered in an outpatient clinic in Mumbai in 2001 and 0.2% more than what was seen among schoolchildren in Mysore in another study.

The latest study of 1,022 children aged 13 to 19 found 6.4% having hypertension, 2.7% isolated systolic, 2% isolated diastolic and 1.7% both systolic and diastolic hypertension.

Children with hypertension had a faster heart rate and high obesity levels.

“For children, these figures are worth serious consideration,” Anoop Misra, principal investigator of the study, said.

Others who contributed to the research article published in British medical journal Archives of Disease in Childhood were Naval Vikram of AIIMS, Delhi, Ruchika Goel of University of Pittsburg Medical Centre and Sunil K Agarwal of Gillings School of Global Public Health, University of North Carolina.

Hypertension among adolescents is often unrecognised, underdiagnosed and unmanaged. Epidemiological studies among children, mostly in Western countries, often relate obesity to hypertension. High blood pressure is also related to family history and is partly mediated by a shared environment, including higher fat and salt intake, lower fruit and vegetable intake and lower physical activity. Waist circumference and triglycerides are the strongest predictors of hypertension.

High hip-waist circumference, obesity and a family history of blood pressure are often indicators of hypertension among children.

“Hypertension in children may be present with headache, blurred vision, lack of concentration, giddiness, and poor scholastic performance, etc,” Misra said, urging parents to keep a watch on such symptoms.

The study claims those in the highest quartiles of various measures of obesity are more likely to be hypertensive than those in the lowest quartiles.

“Hypertension among children is grossly underdiagnosed in India because nobody checks their blood pressure during medical examination,” Misra said.

About one-third of overweight or obese children and adolescents exhibit features of the metabolic syndrome. Since the syndrome continues into adulthood, its manifestations need to be recognised early for prevention of diabetes and coronary heart disease, the authors said.

According to Misra, given its strong association with obesity and family history hypertension should be investigated in both paediatric and adult clinics and its presence could serve as a strong motivation for family lifestyle changes. Identification of hypertension and obesity in parents could prompt screening of other members of the family, including children. Also, lifestyle management could lessen hypertension and other cardiovascular risk factors often seen in Indian children.