Prevalence of Hypertension in Nigerian Children and Adolescents: A Systematic Review and Trend Analysis of Data from the Past Four Decades

Prevalence of sustained hypertension and obesity among urban and rural adolescents: a school-based, cross-sectional study in North India

OBJECTIVE

Recent data on sustained hypertension and obesity among school-going children and adolescents in India are limited. This study evaluates the prevalence of sustained hypertension and obesity and their risk factors among urban and rural adolescents in northern India.

SETTING

A school-based, cross-sectional survey was conducted in the urban and rural areas of Ludhiana, Punjab, India using standardised measurement tools.

PARTICIPANTS

A total of 1959 participants aged 11-17 years (urban: 849; rural: 1110) were included in this school-based survey.

PRIMARY AND SECONDARY OUTCOME MEASURES

To measure sustained hypertension among school children, two distinct blood pressure (BP) measurements were recorded at an interval of 1 week. High BP was defined and classified into three groups as recommended by international guidelines: (1) normal BP: <90th percentile compared with age, sex and height percentile in each age group; (2) prehypertension: BP=90th-95th percentile; and (3) hypertension: BP >95th percentile. The Indian Academy of Pediatrics classification was used to define underweight, normal, overweight and obesity as per the body mass index (BMI) for specific age groups.

RESULTS

The prevalence of sustained hypertension among rural and urban areas was 5.7% and 8.4%, respectively. The prevalence of obesity in rural and urban school children was 2.7% and 11.0%, respectively. The adjusted multiple regression model found that urban area (relative risk ratio (RRR): 1.7, 95% CI 1.01 to 2.93), hypertension (RRR: 7.4, 95% CI 4.21 to 13.16) and high socioeconomic status (RRR: 38.6, 95% CI 16.54 to 90.22) were significantly associated with an increased risk of obesity. However, self-reported regular physical activity had a protective effect on the risk of obesity among adolescents (RRR: 0.4, 95% CI 0.25 to 0.62). Adolescents who were overweight (RRR: 2.66, 95% CI 1.49 to 4.40) or obese (RRR: 7.21, 95% CI 4.09 to 12.70) and reported added salt intake in their diet (RRR: 4.90, 95% CI 2.83 to 8.48) were at higher risk of hypertension.

CONCLUSION

High prevalence of sustained hypertension and obesity was found among urban school children and adolescents in a northern state in India. Hypertension among adolescents was positively associated with overweight and obesity (high BMI). Prevention and early detection of childhood obesity and high BP should be strengthened to prevent the risk of cardiovascular diseases in adults.

Hypertension among adolescents in Nigeria: a retrospective study of adolescent university freshmen

PURPOSE

The burden of hypertension is rising both globally and in Africa specifically. We determined the prevalence of hypertension and the risk factors for clinical hypertension in a population of new university intakes over a 4-year period.

METHODS

We analyzed retrospectively, the records of 6980 older adolescents (15-19 years). We used population-specific metrics to categorize blood pressure (BP) based on the 2017 Clinical Practice Guidelines by the American Academy of Pediatrics.

RESULTS

The overall prevalence of high BP in our study was 25.1% [95% confidence interval (CI) 24.1-26.2] for elevated BP, 19.8% (95% CI 18.9-20.8) for stage 1 hypertension, and 5.5% (95% CI 5.0-6.1) for stage 2 hypertension. The prevalence of stage 2 hypertension was 8.7% (7.5-9.5) among the male participants and 3.2% (95% CI 2.7-3.2) among the female participants (p < 0.001). The multivariate analyses demonstrated an increased risk of high levels of BP (p < 0.001) with age (1.21: 95% CI 1.16-1.26), waist-to-height ratio (WHtR) (1.05: 95% CI 1.04-1.05), z-score for body mass index (BMI) (1.47: 95% CI 1.41-1.54), and hemoglobin concentration (1.10: 95% CI 1.09-1.12). It demonstrated a reduced risk of high levels of BP (p < 0.001) being female (0.35: 95% CI 0.32-0.39).

CONCLUSIONS

Hypertension, its risk factors and the risk of cardiovascular diseases in later life are prevalent in our Nigerian adolescent population. There is, therefore, a need for the development, evaluation and implementation of context-appropriate strategies and interventions to mitigate the risk of hypertension among adolescents, and cardiovascular diseases later in life.

Prevalence of hypertension and prehypertension among children and adolescents in a semi-urban area of Uyo Metropolis, Nigeria

Introduction

In the past, Hypertension in childhood was not considered a problem but in the last few decades, it has gradually become a source of concern especially as children are known to maintain their blood pressures into adulthood. Therefore, hypertensive children are at risk of developing cardiovascular complications earlier in adulthood. In our own environment, the prevalence of hypertension in children is undocumented, hence the purpose of this study.

Methods

Two hundred children aged between 3-17 years were recruited into this study from two public schools-one primary, one secondary in a semi urban community in Uyo metropolis. The blood pressure of respondents was measured in accordance with the technique described by the 4^th Task Force on Blood Pressure Control in Children. The height and weight of all eligible subjects was measured using a stadiometer and a calibrated scale respectively. Body Mass Index (BMI) was assessed for each subject and World Health Organization (WHO) charts of BMI for age and sex were used as reference standards. Waist circumference was measured according to the technique described in the National Health and Nutrition Examination Survey.

Results

The prevalence of hypertension and prehypertension was found to be 3.5% and 2.5% respectively in this study. Only age (OR = 1.74, p = 0.005, 95%CI = 1.186-2.566), BMI (OR = 1.54, p = <0.001, 95% CI = 1.249-1.913) and waist circumference (OR = 1.16, p = 0.002, 95%CI = 1.056-1.271) were found to significantly predict the development of high blood pressure.

Conclusion

The prevalence of hypertension and prehypertension in this study was found to be low. Hypertension/prehypertension was more likely to develop with increasing age, BMI and waist circumference.