The Prevalence of Elevated Blood Pressure and the Association of Obesity in Asymptomatic Female Adolescent Offsprings of Hypertensive and Normotensive Parents
Dr. Nutan Kamath,
Department of Pediatrics,
KMC Hospital, Attavar, Manipal University
Mangalore-575001, Karnataka, India.
Background and objectives: The measurement of the arterial Blood Pressure (BP) is an integral part of every childâ€™s physical examination and it should be interpreted according to the age, gender and the height centiles. Hypertension runs in families and a parental history of hypertension increases the risk of developing hypertension, especially if both the parents have hypertension. The present study was conducted to test this hypothesis and also the hypothesis that hypertensive children are likely to be obese.
Methods: This case control study done on 200 adolescent girls who were aged between 12 to 17 years, who were from a higher primary school in an urban area of Mangalore and on their parents. The blood pressures in the apparently healthy children of the hypertensive and the normotensive parents were compared. The children of the hypertensive parents were defined as the cases and the children of the normotensive parents served as the controls. A calm comfortable setting was provided for the measurement of the BP. Only one researcher performed all the BP measurements and categorized them by using the 2004 fourth report on the blood pressure screening recommendations. The additional measures included the weight and the height. The obesity was determined, based on the Body Mass Index (BMI). The odds ratio (OR) was used for the evaluation of the association between the BP and the obesity, which was based on the BMI.
Results: A total of 203 adolescent girls were given proformas to be completed by their parents. Three parents did not give their consent. Two hundred children and their parents participated in this study. The prevalence rate of hypertension in this study was 11%. Among these 22 hypertensive children, 9 (40.9%) had positive family history of hypertension (the parents had high BP), while the remaining 13 (59.1%) children had normotensive parents. The mean weight and height in the cases were 45.52 Â± 9.23 kg and 156.80 Â± 9.19cm. The mean weight and height in the controls were 43.65 Â± 8.68 kg and 155.22 Â± 10.15cm. The mean systolic BP increased with the increasing body weight ( p < 0.05). The children with hypertension and without hypertension had a mean BMI of 2.06 Â± 0.44 (mean Â± SD) gm/cm2 and 1.76 Â± 0.29 gm/cm2 respectively. Obesity was associated with hypertension (50% vs. 8.9% , p < 0.001).
Interpretation and Conclusions: This study confirmed a high prevalence of hypertension in the asymptomatic, healthy, adolescent girls. The blood pressure in the apparently healthy children of the hypertensive and the normotensive parents was comparable, thus refuting our hypothesis. Obesity was a significant predictor of hypertension, based on the BMI (OR 50.882; 95% CI: 17.25-150.091). Hence, BP measurements must be a part of the routine clinical examination.