Adult Hypertension and Familial Aggregation of Blood Pressure Abnormalities in Children: A Community-Based Cross-Sectional Study in Rural Karimnagar, Telangana, India

Background: Hypertension is a leading modifiable cardiovascular risk factor, and blood pressure (BP) in childhood tracks into adulthood. Parental hypertension may identify children who need early BP assessment. Objectives: To estimate adult hypertension prevalence and its correlates in rural Telangana, and to quantify child BP abnormality by parental hypertension status. Methods: A community-based cross-sectional study was conducted in Nagnoor village, Karimnagar district, from 15 January to 14 July 2024. Systematic household sampling enrolled 500 adults (18–82 years); 216 co-resident children (6–17 years) from 142 households were also assessed. Adult BP was classified by the 2017 ACC/AHA criteria and child BP by the 2017 AAP guideline with repeat-visit confirmation. Analysis used chi-square tests, relative risks and multivariable logistic regression. Results: Adult hypertension prevalence was 26.8% (134/500; 95% CI 23.1–30.8). Independent correlates were age ≥45 years (aOR 2.84; 95% CI 1.76–4.58), BMI ≥23 kg/m² (2.41; 1.52–3.82), salt intake >6 g/day (2.15; 1.38–3.35), tobacco use (1.92; 1.21–3.05) and physical inactivity (1.78; 1.12–2.83). Abnormal BP was found in 25/216 children (11.6%; 95% CI 8.0–16.5): 17 elevated BP and 8 hypertension. Prevalence was 3.7% (4/109) when neither parent was hypertensive, 15.3% (13/85) with one hypertensive parent and 36.4% (8/22) with both (χ² = 21.0, df = 2, p < 0.001; trend p < 0.001). Relative risks versus neither parent were 4.16 (1.40–12.38) and 9.91 (3.25–30.23). Conclusion: Child BP abnormality rose stepwise with parental hypertension. Opportunistic BP measurement of children in households of hypertensive adults is a practical primary-prevention target; the cross-sectional design does not permit causal inference.