Role of Nutritional and Environmental Factors in the Development of Essential Hypertension among School‑going Adolescents in Chennai, Tamil Nadu

Shreemathee Baskar, Nisha B, Gomathy Parasuraman Dutta, Ruma Dutta, Timsi Jain

Abstract


Background: Essential hypertension is one of the fastest rising noncommunicable diseases among adolescents and poses a major public health issue globally. This study aimed to estimate the prevalence of prehypertension and hypertension among school‑going adolescents in Chennai and also to delineate the role of nutritional and environmental determinants in the development of hypertension. Methods: This cross‑sectional study was conducted among school‑going adolescents aged 14 to 18 years in northern Chennai. Four schools (two private, two public) out of 21 were selected randomly using probability proportionate to sampling size and 401 students were recruited after consent. Data were collected using an adapted modified World Health Organization (WHO) Global School‑based student Health Survey (GSHS) questionnaire; anthropometry and blood pressure measurements were done by trained healthcare professionals using standard procedures. Prehypertension was defined when systolic or diastolic pressure >90th percentile and <95th percentile; hypertension when systolic or diastolic pressure >95th percentile. Data were analyzed using SPSS, descriptive statistics like frequencies, mean, and percentages were used and inferential statistics like Chi‑square test and logistic regression were used to elicit predictors of essential hypertension. Results: Out of 401 participants, 185 (46.1%) were males and 216 (53.9%) were females. Overall prevalence of prehypertension and hypertension was 14.2% and 5.5%, respectively. Gender (P = 0.039), overweight/obese (P = 0.000), junk food intake for >3 days/week (P = 0.000), physical inactivity for <3 days/week (P = 0.000), and parent’s history (P = 0.005) were significant determinants in the development of prehypertension and hypertension. Conclusions: Nutritional and environmental determinants play a critical role in influencing blood pressure status among adolescents, this requires lifestyle and behavioral modification.

Keywords


Adolescent; environmental factor; essential hypertension; nutritional; prehypertension

Full Text:

PDF

References


Sivagurunathan C, Umadevi R, Rama R, Gopalakrishnan S.

Adolescent health: Present status and its related programmes

in India. Are we in the right direction? J Clin Diagn Res

;9:LE01.

Epidemiology and global burden of hypertension‑Oxford

Medicine. Available from: https://oxfordmedicine.com/

view/10.1093/med/9780198784906.001.0001/med 9780198784906-chapter ‑61.

Probability of dying between exact ages 30 and 70 from

any of cardiovascular disease, cancer, diabetes, or chronic

respiratory (%). Available from: https://www.who.int/data/gho/

data/indicators/indicator-details/GHO/probability‑of‑dying‑betwe

en‑exact‑ages-30‑and-70‑from‑any‑of‑cardiovascular‑disease‑can

cer‑diabetes‑or‑chronic‑respiratory‑(‑).

Ramadass S, Gupta SK, Nongkynrih B. Adolescent health in

urban India. J Fam Med Prim Care 2017;6:468‑76.

Prevalence of hypertension among adolescents (10‑19 years) in

India: A systematic review and meta‑analysis of cross‑sectional

studies. Available from: https://journals.plos.org/plosone/article?id

=10.1371/journal.pone. 0239929.

Vedavathy SS. Prevalence of hypertension in urban school

going adolescents of Bangalore, India. Int J Contemp Pediatrics

;3:416‑23.

Tony L, Areekal B, Surendran Nair AT, Ramachandran R,

Philip RR, Rajasi RS. Prevalence of hypertension and

pre‑hypertension among adolescent school children in

Thiruvananthapuram, Kerala, India. Int J Community Med Public

Health 2016;312:79‑81.

Sundar J. Prevalence and determinants of hypertension among

urban school children in the age group of 13‑17 years in,

Chennai, Tamil Nadu. IOSR J Dent Med Sci 2013;8:14‑20.

Amma GM, Vasudevan B, Akshayakumar S. Prevalence and

determinants of prehypertension and hypertension among

adolescents: A school based study in a rural area of Kerala,

India. Int J Res Med Sci 2015;3:58‑64.

Ross WD, Marfell‑Jones MJ. Kinanthropometry. In:

Mac‑Dougall JD, Wenger HA, Geen HJ, editors. Physiological

Testing of Elite Athlete. London: Human Kinetics; 1991.

p. 223‑308.

About Child and Teen BMI [Internet]. Centers for Disease

Control and Prevention. Available from: https://www.cdc.gov/

healthyweight/assessing/bmi/childrens_bmi/about_childrens_bmi.

html. [Last accessed on 2022 Jan 29].

Sinha R, Saha A, Samuels J. American academy of pediatrics

clinical practice guidelines for screening and management of

high blood pressure in children and adolescents: What is new?

Indian Pediatr 2019;56:317‑21.

Pardede SO, Yunilasari SD. Prevalence and factors that influence

hypertension in adolescents in Central Jakarta. Am J Clin Med

Res 2017;5:43‑8.

Singh SK, Verma A. Prevalence of hypertension among school

going adolescent boys in Najafgarh, Delhi, India. Int J Adolesc

Med Health 2020;33. doi: 10.1515/ijamh‑2019‑0005.

Nkeh‑Chungag BN, Sekokotla AM, Sewani‑Rusike C,

Namugowa A, Iputo JE. Prevalence of hypertension and

pre‑hypertension in 13‑17 year old adolescents living in

Mthatha‑South Africa: A cross‑sectional study. Cent Eur J Public

Health 2015;23:59‑64.

Dubey RK, Oparil S, Imthurn B, Jackson EK. Sex hormones and

hypertension. Cardiovasc Res 2002;53:688‑708.

Deshpande SR, Rathod PG, Mankar S, Narlawar U, Ughade S.

Systemic hypertension and pré‑hypertension among school going

adolescents: A cross‑sectional study. J Comm Health Manag

;4:18‑23.

Grillo A, Salvi L, Coruzzi P, Salvi P, Parati G. Sodium intake

and hypertension. Nutrients 2019;11:1970.

Qaddumi J, Holm M, Alkhawaldeh A, Albashtawy M,

Omari OA, Batiha AM, et al. Prevalence of hypertension and

pre‑hypertension among secondary school students. Int J Adv

Nurs Stud 2016;5:240.

Charan J, Buch N, Goyal JP, Kumar N, Parmar I, Shah VB.

Prevalence of hypertension in school going children of Surat

city, Western India. J Cardiovasc Dis Res 2011;2:228‑32.

Stapleton PA, James ME, Goodwill AG, Frisbee JC. Obesity and

vascular dysfunction. Pathophysiology 2008;15:79‑89.

Iannuzzi A, Licenziati MR, Acampora C, Renis M,

Agrusta M, Romano L, et al. Carotid artery stiffness in

obese children with the metabolic syndrome. Am J Cardiol

;97:528‑31.

Mahanta TG, Mahanta B, Deuri A, Baruah S, Rasailey R,

Mahanta B. Determinants of hypertension amongst school going

adolescents aged 13–15 yrs in Assam. Clin Epidemiol Global

Health 2018;6:137‑42.

Egan BM. Physical activity and hypertension: Knowing is not

enough; We must apply. Willing is not enough; We must do—

von Goethe. Hypertension 2017;69:404‑6.