Prevalence of elevated blood pressure and hypertension based on repeat measurements among school-going adolescents in Central India

BACKGROUND: Scarcity of evidence regarding the need to obtain three separate Blood Pressure (BP) readings before diagnosing hypertension in adolescents exists in low middle income countries. Hence, this study aimed at determining the prevalence of elevated BP / hypertension in any two of the three visits among 10-18 years school-going adolescents. Secondly, to determine the trajectory of BP readings across age group, sex and over three visits. METHODS: A longitudinal study was conducted across five urban schools of Bhopal district (Madhya Pradesh) among children aged 10-18-years. Multistage cluster sampling was adopted to cover a sample size of 780 over a one-year period. Those adolescents who satisfied the study criteria were checked for height and weight, followed by measurement of auscultatory BP readings on three different occasions, one week apart in each student. Three BP readings were obtained in each of the three settings at f-minute interval. The R shiny app was used to classify hypertension and compute systolic and diastolic percentiles. RESULTS: The overall prevalence of elevated BP/hypertension in adolescents was 1.4% (N = 795), with 2.6% in boys and 0.2% in girls. There was a significant difference in the systolic and diastolic BP percentiles between boys and girls (N = 767) obtained during the second (P < 0.001) and third visit (P < 0.001). Also, significant changes in systolic and diastolic percentile across the three visits were observed (P < 0.001) (N = 767). CONCLUSION: The overall prevalence of elevated BP/HTN was one in hundred adolescents. Also, considering two out of three visits as a criteria for diagnosing HTN needs to be clarified and validated in a larger sample size and with further clinical follow-up to guide policymakers and suggest recommendations.