Punjab: The problem of high blood pressure is continuously increasing among urban school children
Punjab: A study conducted by Dr. Bishav Mohan, Dr. Gurpreet Singh Wander, Dr. Naveen Kumar, Dr. Naved Aslam, Dr. Aditya Rangbulla, Dr. S Kumbhkarni and Dr. Naresh K. Sood from the Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana, found that hypertension (BP) and obesity in adolescents, along with their multiple health consequences such as dyslipidaemia, abnormal plasma glucose and metabolic disorders, have increased dramatically in the last two decades due to rapid socio-economic, nutritional and epidemiological changes worldwide. Early detection of these cardiovascular risk factors (hypertension and obesity) is an important public health priority as it can potentially prevent adverse outcomes of cardiovascular diseases in adulthood. The rising trend of hypertension is a worldwide phenomenon. Data on sustained hypertension among school-going children in India are very low. This study was conducted using standard criteria to evaluate the prevalence of sustained hypertension and obesity among apparently healthy school-going children in rural and urban areas of Ludhiana.
Selection of schools and study participants: There are a total of 1,864 schools in Ludhiana district, of which 317 are in urban and 1,547 in rural areas. The schools were selected by simple random sampling strategy, considering the proportion of population as sample size and within 2 km radius of schools, which were included in the first cross-sectional study conducted in 2004. Then children (adolescents) aged 11-17 years in a given school were selected using a stratified sampling strategy, considering each class as a stratum and the sample size required for that school was divided equally across all classes. From each class, students were again selected by simple random sampling method.
Methods and Results: A total of 2,467 apparently healthy adolescent school children aged 11-17 years from urban area and 859 students from rural area were taken as subjects. Out of a total of 3,326 students, 189 were diagnosed with hypertension; In urban areas, the prevalence of persistent hypertension was 6.69% (n=165) and in rural area it was 2.56% (n=24). Men were more than women in both rural and urban areas. The mean systolic and diastolic blood pressure of hypertensive population in both urban and rural population was significantly higher than the systolic and diastolic blood pressure of their normal blood pressure (having or showing normal blood pressure) counterparts. Overweight population was significantly higher in urban area. 287 (11.63%) were overweight students and 58 (2.35%) were obese. In rural population, overweight and obese students were 44 (4.7%) and 34 (3.63%) respectively. Prevalence of hypertension was 4.52% in people with normal body mass index, 15.33% in overweight people and 43.10% in obese people. In rural area, overweight students showed prevalence of sustained hypertension in 6.82% and in obese group it was 61.76. In rural area no student with normal body mass index was found to have hypertension. The mean body mass index of hypertensive population in both rural and urban areas was significantly higher than the corresponding normal population. Conclusion: Prevalence of sustained hypertension is increasing in urban areas even in younger age groups. Blood pressure is more frequently observed in obese children as compared to lean subjects. This is possibly related to their sedentary life style, changed eating habits, increased fat content in diet and decreased physical activities.
