Prevalence and determinants of prehypertension and hypertension among adolescents: a school based study in a rural area of Kerala, India.

ABSTRACT

Background: Raised blood pressure is the leading cause of death and disability world-wide. Though hypertension is a problem of adults the aetiologic process and risk behaviours start early in life. The objective of the study was to assess the prevalence and determinants of prehypertension and hypertension among adolescents from high schools in a rural area of Kerala, India. Methods: A cross sectional analytical study was carried out in 1000 adolescents from randomly selected Government, Aided and Unaided high schools of Ettumanoor, Kerala proportionate to sampling frame using WHO designed Global School based student Health Survey (GSHS) questionnaire. Anthropometry and blood pressure recordings were done by trained team members. Statistical analysis was done using SPSS 21. Chi-square test was used to find out the association between categorical variables. Significant variables were entered into logistic regression model to find out Adjusted Odds Ratio (AOR). Results: Out of 1000 study subjects, 409(40.9%) were males and 591(59.1%) were females. Overall prevalence of prehypertension and hypertension was 24.5% (males-30.5%, females-20.3%) and 0.6% (males-0.98%, females-0.34%) respectively. Male sex (AOR-1.67 95%CI-1.23-2.28), low socio-economic status (AOR-1.55 95%CI-1.15-2.11), overweight/obese (AOR-5.7 95%CI- 2.4-13.6), low fruit consumption (AOR-2.02 95% CI-1.499-2.7) and high soft drink consumption (AOR-2.21 95%CI- 1.446-3.39) were the significant risk factors for prehypertension and hypertension. Conclusion: Male sex, Low socio-economic status, obesity/overweight, low fruit and high soft drink consumption are the significant determinants of Pre hypertension and hypertension among adolescents. The findings may be used in developing messages to provide awareness of dangers of raised blood pressure among adolescents and its behavioural determinants.