HYPERTENSION
1. Context:
High blood pressure is occurring in one in 3-4 children & this is much higher than earlier estimates of about 7% elevated blood pressure is more prevalent in poorer than the richest category.
35% of children aged 10-12 years & 25% of children above 13 years have hypertension.
2. Key Points:
- High blood pressure is a problem of great magnitude in India.
- High blood pressure is relatively silent, with grave consequences, as it is a major cause of cardiovascular diseases.
- The Indian National Health Portal reports that 30% adult Indians have elevated blood pressure, a little higher in urban (34%) than in rural (28%) areas.
- Hypertension is associated with affluence & will not occur in undernourished children.
- Elevated blood pressure is more prevalent in poorer than the richest category. It also occurs with similar frequency in rural & urban areas.
- High blood pressure prevalence in younger stunted adolescents is 40% compared with 34% in those not stunted.
- Hypertension prevalence in thin/underweight adolescents is also high 32% in younger & 22% in older adolescents.
- Higher prevalence of high blood pressure in rural areas may be due to rapid urbanisation, lower level of physical activity.
| Chhattisgarh, Odisha, Telangana, Andhra Pradesh, Manipur, Mizoram, Tripura & Nagaland have higher hypertension prevalence compared with rest of India. |
3. Widespread:
- Hypertension in adolescents is more widely prevalent than previously thought & bodes ill for the next generation of adults.
- Comprehensive National Nutrition Survey (CNNS), used a statistically appropriate method to sample adolescents without illness, aged 10-19 years, across the country.
- Hypertension is often clustered with other cardio-metabolic risk factors including overweight & obesity.
- Adolescents with high fasting blood glucose, haemoglobin A1c, serum triglyceride & LDL cholesterol levels have a greater risk of high blood pressure.
- Blood pressure was measured rigoursly & high blood pressure was defined based on the mean of second & third readings as per 2017 American Academy of Pediatrics cut-offs, as height-adjusted blood pressure above the 95th percentile below 13 years & greater than 130/80 mm Hg in older adolescents.
4. Urbanisation:
- Higher prevalence of high blood pressure in rural areas may be attributed to rapid urbanisation, resulting in altered dietary habits, more screen time & lower level of habitual physical activity.
- One causative factor that is relevant in India today is the explosion of ready-to-eat processed foods & snacks, which depend on a high salt & sugar content.
- Data from the NSSO survey of 2011-12 show that the highest salt-consuming states consume over 9 grams/day, while the median intake for India is about 8 grams/day.
- There is a need to screen & identify adoloescents with hypertension, preventive interventions to control the burden of hypertension & its consequences in India.
- This is important as many people with hypertension, particularly in India are not aware of their disease & the detection, treatment & control of it should be an urgent health priority.
