Study of blood pressure profile and anthropometry in children belonging to low socio-economic status; a prospective cross sectional study

Authors

  • Chidambram Sudhakar Department of Pediatrics, Chandulal Chandrakar Memorial Hospital, Bhilai, District Durg, Chhattisgarh, India
  • Raisur Rahman Department of Pediatrics, Chandulal Chandrakar Memorial Hospital, Bhilai, District Durg, Chhattisgarh, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20172024

Keywords:

CBlood pressure, Children, Hypertension, Malnutrition

Abstract

Background: A significant number of population in India are below poverty line. It contributes to the higher incidence of malnutrition especially among children which is 48% according to NFHS-3 (National family Health survey). Blood Pressure tracking studies suggest that hypertension in adulthood often has its origin in childhood. Blood pressure in childhood is the best predictor of hypertension in later life. There have been very few studies on malnutrition and Hypertension association and none in this area. One rationale for screening for hypertension in children and adolescents is that early identification of primary hypertension could lead to interventions to reduce blood pressure during childhood and adolescence, resulting in a reduced risk for cardiovascular events and death in adulthood.

Methods: The present cross sectional prospective study was conducted on School going children (5-14 years) belonging to lower socio-economic status attending schools from Bhilai, DistrictDurg Chhattisgarh, India, within 5 km range of Chandulal Chandrakar Memorial Hospital over a period of 12 months from March 2015 to February 2016.The present study took 300 sample size. List of schools was arranged from district education officer (DEO) and required government schools were shortlisted on within 5 km range of hospital. After short history and examination, as per the prerequisite of proforma, the following measurements were taken. For all the statistical analysis MS EXCEL and SPSS 16 (Statistical Package for Social Science) version were used. The information collected was tabulated and the data was analyzed using suitable statistics.

Results: 60% of the subjects were belongs to 5-10 years of age and 40% in 10-14 years’ age group. Males and females were equal in distributions (50% each), thus there were 150 males and 150 females in the current study. Overall prevalence of malnutrition in our study was 38.6%. The present study found 88 subjects (29.3%) having grade 1 malnutrition and 28 subjects (38.7%) having grade 2 and 0 (0%) with grade 3 and grade 4 malnutrition. There were 2 pre-hypertensives in our study, out of which one was male and one female. When analyzed according to nutritional status, there were 2 hypertensives in malnourished group. Similarly. there was 1 hypertensive in normal nutritional status group.

Conclusions: There is a significant prevalence of malnutrition in our society which contributes to a more number of problems than what is presented to practicing paediatricians. The prevalence is higher in children <5 years age group overall which continues through school age and adolescent age group as shown in our study. The focus of attention should be identification of various diseases along with hypertension at the earliest and prevention of malnutrition.

References

Szklo M. Epidemiologic patterns of blood pressure in children. Epidemiol Rev. 19791;1(1):143-69.

Mahoney LT, Clarke WR, Burns TL, Lauer RM. Childhood predictors of high blood pressure. Am J Hyper. 1991;4(11):608S-10.

Shear CL, Burke GL, Freedman DS, Berenson GS. Value of childhood blood pressure measurements and family history in predicting future blood pressure status: results from 8 years of follow-up in the Bogalusa Heart Study. Pediatr. 1986;77(6):862-9.

Cook NR, Gillman MW, Rosner BA, Taylor JO, Hennekens CH. Prediction of young adult blood pressure from childhood blood pressure, height, and weight. J Clin Epidemiol. 1997;50(5):571-9.

Update on the 1987 task force report on High Blood Pressure in Children and adolescents: A working group from the national high blood pressure education programme on HT. control in children and adolescents. Paediatr 1996;98:649-58.

Lucini D, Mela DS, Malliani A, Pagani M. Impairment in Cardiac Autonomic Regulation Preceding Essential hypertension in Humans: Insights from Spectral Analysis of Beat-to-Beat Cardiovascular Variability. Circulat. 2002;106:2673-9.

Report of second task force in BP control in children Paediatr. 1977;59:797-820.

Ene-Obong H, Ibeanu V, Onuoha N, Ejekwu A. Prevalence of overweight, obesity, and thinness among urban school-aged children and adolescents in southern Nigeria. Food Nutrit Bullet. 2012;33(4):242-50.

Sesso R, Barreto GP, Neves J, Sawaya AL. Malnutrition is associated with increased blood pressure in childhood. Neph Clin Pract. 2004;97(2):61-6.

Grotto I, Huerta M, Sharabi Y. Hypertension and socioeconomic status. Current Opinion Cardiol. 2008;23(4):335-9.

UNICEF. The state of the world's children. Adolescence: Children with disabilities; 2013.

Arnold F, Parasuraman S, Arokiasamy P, and Kothari M. Nutrition in India. National Family Health Survey (NFHS-3), India, 2005-06. Mumbai: International Institute for Population Sciences; Calverton, Maryland, USA: ICF Macro; 2009.

Ramalingaswami V, Johnsson U, Rohde J: The Asian Enigma. Progress of Nations. New York: United Nations Children's Fund; 1996.

Park K. Parks Textbook of Preventive and Social Medicine. 19th ed. Jabalpur: Banarsidas Bhanot; Nutrition and health; 2007:507.

Gragnolati M, Shekar M, Gupta MD, Bredenkamp C, Lee YK. India's Undernourished Children: A Call for Reform and Action. Washington, DC: World Bank; 2005.

Questionnaire Reporting Software with The Survey System. Creative research system. Available on. https://www.surveysystem.com/sscalc.html.

Moyer VA; U.S. Preventive Services Task Force. Screening for primary hypertension in children and adolescents: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2013;159:613-9.

Mourad A, Carney S, Gillies A, Jones B, Nanra R, Trevillian P. Arm position and blood pressure: a risk factor for hypertension? J Human Hypert. 2003;17(6):389-95.

Netea RT, Lenders JW, Smits P, Thien T. Both body and arm position significantly influence blood pressure measurement. J Human Hypert. 2003;17(7):459-62.

Rocchini AP. Coarctation of the aorta and interrupted aortic arch. Pediatric Cardiovascular Medicine. New York, NY: Churchill Livingstone. 2000;570.

Prineas RJ, Ostchega Y, Carroll M, Dillon C, McDowell M. US demographic trends in mid-arm circumference and recommended blood pressure cuffs for children and adolescents: data from the National Health and Nutrition Examination Survey 1988-2004. Blood pressure monitoring. 2007;12(2):75-80.

Prineas RJ, Jacobs D. Quality of Korotkoff sounds: bell vs diaphragm, cubital fossa vs brachial artery. Prevent Med. 1983;12(5):715-9.

Lewington S, Clarke R, Qizilbash N, Peto R, Collins R. Prospective studies collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002;360(9349):1903-13.

Londe S, Klitzner TS. Auscultatory blood pressure measurement-effect of pressure on the head of the stethoscope. Western J Med. 1984;141(2):193.

Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, et al. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. Jama. 2003;289(19):2560-71.

Brotons C, Singh P, Nishio T, Labarthe DR. Blood pressure by age in childhood and adolescence: a review of 129 surveys worldwide. Int J Epidemiol. 1989;18(4):824-9.

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 Hypert. 1988;6(8):647-53.

Zhang YX, Wang SR. Comparison of blood pressure levels among children and adolescents with different body mass index and waist circumference: study in a large sample in Shandong, China. Eu J Nutr. 2014;53(2):627-34.

Luepker RV, Steffen LM, Jacobs DR, Zhou X, Blackburn H. Trends in blood pressure and hypertension detection, treatment, and control 1980 to 2009 the Minnesota Heart Survey. Circulat. 2012;126(15):1852-7.

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.

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.

Anand, NK, Tandon L. Prevalence of hypertension in school going children. Indian Paediatr. 1996;33:377-81.

Rajaram S, Zottarelli LK, Sunil TS: Individual, household, programme and community effects on childhood malnutrition in rural India. Mater Child Nutr. 2007;3:129-40.

Kanjilal B, Mazumdar PG, Mukherjee M, Rahman MH. Nutritional status of children in India: household socio-economic condition as the contextual determinant. Int J Equit Health. 2010;9(1):1.

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Published

2017-06-21

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Original Research Articles