Study of blood pressure profile and correlation of hypertension with age, sex, anthropometric measurements (weight, height, body mass index), socio economic status and hereditary factors in school going children


  • Kamatham Madhusudhan Department of Pediatrics, Gandhi Medical College, Secunderabad, Telangana, India
  • Rajendra Betham Department of Pediatrics, Gandhi Medical College, Secunderabad, Telangana, India
  • Venkateswara Rao Jampana Department of Pediatrics, Gandhi Medical College, Secunderabad, Telangana, India



BMI, Hypertension, School children, Systolic blood pressure


Background: Pre hypertension in childhood is a precursor of hypertension in adulthood. Weight, height and body mass index (BMI) can be taken as surrogate marker of prevalence of hypertension and hence measurement of these parameters can help in early detection of children at risk of hypertension. The present study was done to determine the correlation of hypertension with age, gender, anthropometric measurements, socioeconomic status, and hereditary factors and to estimate the prevalence of hypertension and pre hypertension.

Methods: It is an observational study involving 1009 healthy urban school children of 5 to 15 years of age. Height and weight were taken according to standard techniques (Jelliffee 1966). In order to exclude age as a confounding factor; BMI was plotted on percentile charts.

Results: There was a linear increase of mean blood pressure with increasing age, height and weight. The mean systolic and diastolic blood pressures of children with BMI 85th to 95th percentile (overweight group) and with BMI ≥95th percentile (obese group) were higher than the lower BMI groups. The children belonging to high socio economic status (class I) and those with family history of hypertension were having higher mean values of systolic and diastolic blood pressure. Equal number of children belonged to pre hypertension (65) and hypertension (67) category.

Conclusions: The mean systolic and diagnostic blood pressure was equal in both sexes. Children with overweight/obesity, family history of hypertension and class I socioeconomic status had increased mean values of systolic and diastolic blood pressure. Prevalence of high blood pressure was 13.1% (pre hypertension: 6.44% and hypertension: 6.64%).


Hansen ML, Gunn PW, Kaelber DC. Underdiagnosis of hypertension in children and adolescents. JAMA. 2007;298(8):874-9.

Falkner B, Daniels SR, Flynn JT, Gidding S, Green LA, Ingelfinger JR, et al. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004;114(2III):555-76.

Reid C, chantler C, systemic hypertension, London : Churchill: livingstone; 2002:1966.

Chadha SL, Tandon R, Shekhawat S, Gopinath N. An epidemiological study of blood pressure in school children (5-14 years) in Delhi. Indian Heart J. 1999;51(2):178-82.

Anand NK, Tandon L. Prevalence of hypertension in schoolgoing children. Indian Pediatr. 1996;33(5):377-81.

Gupta AK, Ahmad AJ. Normal blood pressures and the evaluation of sustained blood pressure elevation in childhood. Indian Pediatr. 1990;27(1):33-42.

Laroia D, Sharma M, Diwedi V, Belapurkar KM, Mathur PS. Profile of blood pressure in normal school children. Indian Pediatr. 1989;26(6):531-6.

Agarwal VK, Sharan R, Srivastava AK, Kumar P, Pandey CM. Blood pressure profile in children of age 3-15 years. Indian Pediatr. 1983;20(12):921-5.

Agarwal R, Mandowara SL, Bhandari B, Garg OP. II. Prevalence of hypertension in apparently healthy school children. Indian Pediatr. 1982;19(9):779-84.

Kaelber DC, Pickett F. Simple table to identify children and adolescents needing further evaluation of blood pressure. Pediatrics. 2009;123(6):e972-4.

Jaddou HY, Bateiha AM, Khawaldeh AM, Goussous YM, Ajlouni KM. Blood pressure profile in schoolchildren and adolescents in Jordan. Ann Saudi Med. 2001;21(1-2):123-6.

Subhi MD. Blood pressure profiles and hypertension in Iraqi primary school children. Saudi Med J. 2006;27(4):482-6.

Schiel R, Beltschikow W, Kramer G, Stein G. Overweight, obesity and elevated blood pressure in children and adolescents. Eur J Med Res. 2006;11(3):97-101.

Guyton A, Hall J. Textbook of medical physiology. Philadelphia: Saunders; 2006:161-165.

Ribeiro J, Guerra S, Pinto A, Oliveira J, Duarte J, Mota J. Overweight and obesity in children and adolescents: relationship with blood pressure, and physical activity. Ann Hum Biol. 2003;30(2):203-13.

He Q, Ding ZY, Fong DY, Karlberg J. Blood pressure is associated with body mass index in both normal and obese children. Hypertension. 2000;36(2):165-70.

Uhari M, Nuutinen M, Turtinen J, Pokka T. Pulse sounds and measurement of diastolic blood pressure in children. Lancet. 1991;338(8760):159-61.

Wang WJ, Wang KA, Chen CM, Cao RX, Bai YM, Ma LM, et al. The study on relationship of body mass index and blood pressure in children and adolescents of Beijing. Zhonghua Liu Xing Bing Xue Za Zhi. 2004;25(2):109-12.

Chahar CK, Shekhawat V, Miglani N, Gupta BD. A study of blood pressure in school children at Bikaner. Indian J Pediatr. 1982;49(401):791-4.

Rames LK, Clarke WR, Connor WE, Reiter MA, Lauer RM. Normal blood pressure and the evaluation of sustained blood pressure elevation in childhood: the muscatine study. Pediatrics. 1978;61(2):245-51.

Munger RG, Prineas RJ, Gomez-Marin O. Persistent elevation of blood pressure among children with a family history of hypertension: the minneapolis children's blood pressure study. J Hypertens. 1988;6(8):647-53.

Sachdev Y. Normal blood pressure and hypertension in Indian children. Indian Pediatr. 1984;21(1):41-8.

Hahn L. The relation of blood pressure to weight, height and body surface area in schoolboys aged 11 to 15 years. Arch Dis Child. 1952;27(131):43-53.

Moss AJ. Indirect methods of blood pressure measurement. Pediatr Clin North Am. 1978;25(1):3-13.

Blood pressure, archives, disease of childhood. 1988;63:347-9.

Sinaiko AR, Gomez-Marin O, Prineas RJ. Prevalence of significant hypertension in junior high school-aged children: the children and adolescent blood pressure program. J Pediatr. 1989;114(4 Pt 1):664-9.

William FG. Dynamics of blood and lymph flow US; Lange Medical book; 2001:579-598.

Antoine W, Voor S. Epidemology of essential hypertension in youth. Implication for clinical practice- Pediatr Clin North Am. 1978;25(1):15-25.

Rosner B, Prineas RJ, Loggie JM, Daniels SR. Blood pressure nomograms for children and adolescents, by height, sex, and age, in the United States. J Pediatr. 1993;123(6):871-86.

Petal RC. Persistence systemic hypertension in infants and children. Pediatr Clin North Am. 1974;21(4):801-24.

Rocchini AP. Childhood hypertension: etiology, diagnosis, and treatment. Pediatr Clin North Am. 1984;31(6):1259-73.

Dube SK, Kapoor S, Ratner H, Tunick FL. Blood pressure studies in black children. Am J Dis Child. 1975;129(10):1177-80.

Maguire H, Shelley E. Blood pressure levels among primary school children. Ir Med J. 1990;83(3):90-4.

Londe S, Bourgoignie JJ, Robson AM, Goldring D. Hypertension in apparently normal children. J Pediatr. 1971;78(4):569-77.

Burke GL, Cresanta JL, Shear CL, Miner MH, Berenson GS. Cardiovascular risk factors and their modification in children. Cardiol Clin. 1986;4(1):33-46.

Behjati M, Barhordari K. The relation between blood pressure and body mass index in Iranian school age children. Iran J Med Sci. 2006;31(1):33-6.

Lande MB. Systemic hypertension. In: Behrman R, Kliegman R, Jenson H. Nelson textbook of paediatrics. 19th ed. Philadelphia: W. B. Saunders Co; 2000:1179-1181.






Original Research Articles