To Study the Prevalence of Asymptomatic Hypertension among Adolescent School Going Children Between 10 To 17 Years of Age and to Asses the Risk Factors among them

INTRODUCTION: Blood pressure measurement in childhood and adolescence is an important clinical examination as is the recording of body temperature, pulse rate and respiratory rate. Blood pressure raises with increasing age. Both systolic and diastolic blood pressure show a positive correlation with height and weight in both sexes. The underlying process of growth and maturation is closely linked to the BP in children and adolescents. Even after so much of improvements in the diagnostic techniques, it is often difficult to determine the arterial blood pressure with accuracy in infants and young children. The difficulty encountered is both in the technique and in the interpretation of the reading itself. Although the prevalence of clinical hypertension is of a far lesser magnitude in children than adults, there is ample evidence to support the concept that the roots of essential hypertension extend back into childhood1. The original orientation of physicians with regard to BP in children and adolescents was towards identification and treatment of secondary forms of hypertension, such as renal parenchymal disease and renal artery stenosis. It is now understood that hypertension detected in some children may be a sign of an underlying disease, whereas in other cases the elevated BP may represent the early onset of essential hypertension. Primary prevention of one of the leading health problems like hypertension and ischemic heart disease in adults necessitates a scientific evaluation of the predictors in children and adolescents. Blood pressure studies in these younger age groups provide important epidemiological information which may help in controlling or modifying the risk factors3 thereby decreasing the mortality and morbidity in the future. AIM OF THE STUDY:To Identify Prevalence of (a) Asymptomatic hypertension. (b) Obesity (c) Overweight among school children between 10 - 17 years in Chennai City. To Assess Association of risk factors like age, sex, obesity, overweight, socio economic status, physical activity, hours of watching television, oil consumed, family history of hypertension, family Ho. Diabetes mellitus, to hypertension among these children. DISCUSSION: The dividing line for hypertension was described by Master et al28. as above 95th percentile and by Dube et al.27 + 2 S.D. above mean. Presently, National High Blood Pressure Education Programme (NHBPEP) working group on high Blood Pressure in children and adolescent. The fourth report on diagnosis, evaluation and treatment of high blood pressure in children adolescent 2004 an authentic source of child hood and adolescent hypertension 2004. In this report blood pressure is classified into three categories based on percentile values. In our study, hypertension was adjoined as per recommendation of NHBPEP 2004 update of second Task force (USA). Other authors have reported a varied range of criteria. SUMMARY: 1.Prevalence of Hypertension is 9.5%, among males prevalence is 8.0% and among females it is 10.8%. 2. Prevalence of hypertension among lower socio economic status children is 8.85% as against prevalence rate of 10.2% among children belonging to high socio economic status. 3. Overall prevalence of obesity is 2.7%, among females prevalence is 3.32% and along males prevalence it is 2.00%. 4. Prevalence of overweight is 5.25%, among female overweight prevalence is 7.87% and among male it is 2.17%. 5. Obesity, overweight and family history of hypertension are found to be significant independent risk factors for hypertension among 10 - 17 years old children. CONCLUSION: A) Since the prevalence of asymptomatic hypertension seems to be significant (9.5%) among 10 - 17 years old children. It is mandatory to check the blood pressure atleast once a year in school children. It will be a useful guide for early identification and evaluation of hypertension in later life. B) Since the prevalence of obesity (2.7%) and overweight (5.25%) seems to be significant and associated with increased risk of hypertension, life style modification in the form of dietary habits like restricted salt intake, avoiding junk food consumption and oil food stuffs, Increased physical activity and relaxation techniques will decrease the overweight and obesity and indirectly influence to maintain the blood pressure in the normal range. The potential pay off by way of prevention is enormous in terms of later cardiovascular disease and allow the provision of more comprehensive care to the pediatric population