High rates of child hypertension associated with obesity: a community survey in China, India and Mexico

BACKGROUND: Hypertension is a significant risk factor for cardiovascular disease, and epidemiological evidence suggests that it is increasing in parallel with obesity in children and adolescents in low- and middle-income countries. AIM: To identify and determine the relationship between overweight, obesity and hypertension in a community sample of school children. METHODS: Anthropometric data were collected from 12,730 school children aged 12-18 years in China, India and Mexico as part of the Community Interventions for Health programme, an international study evaluating community interventions to reduce non-communicable disease by addressing the three main risk factors of tobacco use, unhealthy diets and physical inactivity. Logistic regression was used to examine the association of body mass index and gender and hypertension. RESULTS: Prevalence rates of hypertension were 5.2% in China, 10.1% in India and 14.1% in Mexico, and pre-hypertension rates in China, India and Mexico were 13.4%, 9.4% and 11.2%, respectively. Overweight and obesity prevalence rates varied by country and were 16.6% in China, 4.1% in India and 37.1% in Mexico. In all countries there was a significant association between overweight and obesity and rates of hypertension. Overweight children were 1.7-2.3 times more likely to be hypertensive and obese children 3.5-5.5 more likely to show hypertension than those of normal weight. CONCLUSIONS: Rates of hypertension and overweight and obesity are high in school children in China, India and Mexico, and increased bodyweight is a significant risk factor for hypertension.