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Year : 2011  |  Volume : 55  |  Issue : 2  |  Page : 121-124  

Blood pressure distribution and its relation to anthropometric measurements among school children in Aligarh

1 Reader, Department of Home Science, Women's College, AMU, Aligarh, India
2 Research Scholar, Department of Home Science, Women's College, AMU, Aligarh, India

Date of Web Publication22-Sep-2011

Correspondence Address:
Anisa M Durrani
Reader, Department of Home Science, Women's College, AMU, Aligarh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0019-557X.85246

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A cross-sectional study among 701 school children (12-16 years) was conducted in Aligarh to find out the prevalence of hypertension and to correlate school going adolescent's blood pressure with age, sex, height and weight. The weight was taken by a standardized weighing machine while height was measured using a standard stediometer. Blood pressure measurements were taken by a mercury sphygmomanometer. The distribution of blood pressure by anthropometric characteristics were studied. Mean, standard deviation and correlation coefficient were used for statistical analysis. The overall prevalence of hypertension was found to be 9.4%. Blood pressure of both gender appear to have positive correlation with anthropometric characteristics. Study recommends that children must be screened regularly for blood pressure so that remedial measure can be initiated as early as possible.

Keywords: Anthropometric measurements, Blood pressure, School children

How to cite this article:
Durrani AM, Waseem F. Blood pressure distribution and its relation to anthropometric measurements among school children in Aligarh. Indian J Public Health 2011;55:121-4

How to cite this URL:
Durrani AM, Waseem F. Blood pressure distribution and its relation to anthropometric measurements among school children in Aligarh. Indian J Public Health [serial online] 2011 [cited 2023 Mar 23];55:121-4. Available from:

Hypertension is a major health problem in developed and developing countries associated with high mortality and morbidity affecting approximately one billion individuals worldwide. [1] Hypertension has its origin in childhood but goes undetected unless specifically looked for during this period. [2] Luepker et al. [3] also observed that although blood pressure normally increases with growth and development, the children with higher levels of blood pressure tend either to maintain that position as they mature or track into higher levels of blood pressure in adulthood in comparisons to their peer group.

A number of community based studies have demonstrated that there is a strong positive relationship between anthropometric measurements and blood pressure in adolescents. [4],[5],[6] Recognition of blood pressure correlate serves to identify groups within a population who are at increased risk of hypertension. Therefore the early detection of hypertension and its causative factors are important to evolve measures to prevent the hypertension and its complications.

Keeping in view the seriousness of problem on one hand and lack of knowledge about the prevalence of hypertension among school children in Aligarh on another, the present study was undertaken among the school children in Aligarh to find out prevalence of hypertension and the relationship of hypertension with anthropometric variable like height and weight.

The present study was conducted during the year 2006-2007. Information were collected from 701 School children in the age group of 12-16 years of age. Study participants were selected by stratified sampling. As per the available record at the office of the municipal corporation of Aligarh twenty seven schools were functioning and the total population in this age group was 46,850. (2006-07). To ensure the representative ness, the city of Aligarh was divided into four specific zones on the geographical layout. One school from each zone was selected on the bases of consent and active cooperation of school authorities. Considering, 11.7% prevalence of hypertension among school children [7] with 20% possible error, the sample size was calculated to be 755 by using the formula N = 4pq/L 2 . 701 school children participated in the study, with response rate of 92.84%.

Information about the socio demographic characteristics was recorded in the predesigned and pretested questionnaire. The weight (Kg) was recorded by using a standardized weighing machine having accuracy up to 0.1 Kg and height (M) was measured using a standard stediometer with accuracy of up to 0.5 cm by applying standard technique.

Blood pressure (BP) measurements were taken using a mercury sphygmomanometer. The average of three consecutive readings at the interval of five minutes was taken as the blood pressure reading of the adolescents. The methodological recommendations of the 1996 Task Force were used for the screening of BP. [8] On the basis of these reading, 5 th to 95 th percentile were computed for each age group, gender wise for both systolic and diastolic blood pressure (SBP and DBP). Hypertension was diagnosed if blood pressure was more than 95 th percentile for the age. [9] Statistical methods included calculation of age and sex wise mean, standard deviation (SD) and correlation coefficient to establish significance level wherever applicable. Statistical analysis was done by SPSS 12 version.

Out of 701 school children 66 (9.4%) were found to be hypersensitive. The prevalence of hypertension among 363 boys and 338 girls were found to be 34 (9.36%) and 32 (9.4%) respectively. The highest prevalence of hypertension was observed in 15 years of age in both sexes (19.51% in boys and 16.66% in girls) followed by 13 years (9.83%) in boys and 16 years (11.61%) in girls. In the present sample the sex differences in the prevalence of hypertension were not statistically significant (P>0.05).

Even with the short span of five years in the study 12-16 years the mean blood pressure increased significantly with age (r = 0.40 for SBP and r = 0.45 for DBP) as evident from [Table 1]. The mean SBP of both sexes 108.62 mm Hg at the age of 12 years and 118.10 mm Hg at the age of 16 years, showed an increase of 9.48 mm Hg increase in the systolic blood pressure. Similarly, the increase of diastolic blood pressure was observed as 7.46 mm Hg for the same group. So, the age effect was found to be more for systolic blood pressure in the present study.
Table 1: Age wise distribution of blood pressure and hypertension in school children

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The result revealed that systolic and diastolic blood pressure of both sexes have a positive correlation (P<0.01) with height, correlation of systolic blood pressure with height was found to be same 0.36 for both boys and girls, and that of diastolic blood pressures 0.36 and 0.41 in boys and girls respectively [Table 2].
Table 2: Frequency distribution of mean SBP and DBP (mm Hg) for adolescents in different height and weight ranges

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In both sexes, a rise is observed in mean systolic and diastolic blood pressure with increase in mean weight [Table 2]. In the present study correlation coefficient of systolic blood pressure with weight was 0.47 and 0.50 and that of diastolic blood pressure was 0.46 and 0.42 in boys and girls respectively.

Hypertension is a major risk factor for cardiovascular and cerebrovascular diseases. Although the prevalence of hypertension is far less in children than in adult, there is enough evidence to suggest the root of essential hypertension extended into childhood. [10] A variety of studies conducted in different parts of the world revealed a vast range in the prevalence of hypertension in children showing as high as 22% to as low as 0.6%. [11] Chadha et al. [7] reported about 11.7% prevalence in school children of Delhi while Anand and Tandon et al. [12] reported 0.4% prevalence of hypertension in the age group of 5-17 years. However, it has been observed that low hypertension in these populations may be mainly due to the use of an arbitrary criterion of hypertension assessment and not the recognized criterion of 95 th percentile of blood pressure values.

The prevalence of hypertension was found to be slightly lower among boys than girls about 9.36% in boys and 9.4% in girls. While Prabhajot et al. [13] found the prevalence of hypertension in Amritsar, Punjab to be 8.3% and 6.52% among boys and girls respectively. The differences in patterns of blood pressure between males and females are probably related to certain biological and psychosocial factors. The appearance of secondary sex characters together with the menarche is associated with a high level of anxiety resulting in higher blood pressure values in girls. A trend of increase in mean values of SBP and DBP with age in the present sample has been observed in both sexes [Table 1].

An increase in blood pressure with body size has been well documented [4],[9],[10],[14] and current study further exemplifies the same, justifying that blood pressure is as much as part of growth and development like weight and height. Voors, et al[15] in the Bogalusa Heart Study suggested that the relationship between age and blood pressure is a correlate of height and a part of biologic maturation.

In our study overall correlation coefficient of height with SBP was 0.36 and 0.38 with DBP. Systolic and diastolic blood pressure of both gender established the positive correlation (P<0.01) with height, which is in accordance with the finding of Gupta et al. [16] , and Saha et al. [17]

The positive correlation of both systolic and diastolic blood pressure with height in the present study confirms the presence of primary hypertension among children and suggests that such children are at risk of developing hypertension at latter stages. The finding recommend that these children should be considered for high risk for developing CVD and type 2 diabetes and must be screened for a close follow up for modification of risk factors.

The correlation coefficient of systolic and diastolic blood pressure of both sexes also showed a positive correlation with weight [SBP r = 0.47 (boys) and 0.50 (girls) and DBP r = 0.46(boys) and 0.42 (female)], which agreed with the finding of Gupta et al. [16] [SBP r = 0.55(male) and 0.58 (female) and DBP r = 0.61(male) and 0.52 (female)]. Whereas the Muscatine study [18] showed positive linear correlation with systolic blood pressure in both genders (r = 0.61 male and 0.51 female) but no correlation was observed between weight and diastolic blood pressure in either genders. (r = 0.30 in both genders). In contrast Singh BM., et al (1994) did not find any linear correlation between blood pressure and body weight (SBP r = 0.30 (male) and 0.20 (female) and DBP r = 0.19 (male) and 0.33 (female) respectively).

Increase in anthropometric measurements were found to be important factor in the development of hypertension in the present study. Mean systolic and diastolic blood pressure were higher as range of height and weight increased and positive significance was found between these variables and blood pressure in both sexes. It is therefore recommended that children must be screened to detect and check the influencing factor like over weight. The high risk children need to be considered for close follow-ups for modification of risk factors by advising life style changes by means of proper diet, regular exercise and weight reduction. Appropriate health education need to be impart at home and school so that these risk factors can be eliminated in early stages itself.

   References Top

1.JNC VII Report. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatments of High Blood Pressure. JAMA 2003;19:2560-72.   Back to cited text no. 1
2.Aggarwal R, Mendoware SL, Bhandari B, Garg OP. Prevalence of hypertension in apparently healthy school children. Indian Pediatr 1982;19:779-89.  Back to cited text no. 2
3.Luepker RV, Jacobs DR, Prineas RJ, Sinaiko AR. Secular trends of blood pressure and body size in a multiethnic adolescent population: 1986 to 1996. J Pediatr 1999;134:668-74 .  Back to cited text no. 3
4.Voors AW, Webber LS, Frerichs RR, Berenson GS. Body height and body mass as determinants of basal blood pressure in children--The Bogalusa Heart Study. Am J Epidemiol 1977;106:101-8.  Back to cited text no. 4
5.Jiang X, Srinivasan SR, Urbina E, Berenson GS. Hyperdynamic circulation and cardiovascular risk in children and adolescents. The Bogalusa Heart Study. Circulation 1995;91:1101-6.  Back to cited text no. 5
6.Muntner P, He J, Cutler JA, Wildman RP, Whelton PK. Trends in blood pressure among children and adolescents. JAMA 2004;291:2107-13.  Back to cited text no. 6
7.Chadha SL, Tandon R, Shekhawat S, Gopinath N. An epidemiological study of blood pressure in school children (5-14 years) in Delhi. Indian Heart J 1999;51:178-82.   Back to cited text no. 7
8.Task Force on Blood Pressure Control in Children. Report of the second Task Force on Blood Pressure Control in Children. Pediatrics 1996;79:1-25.  Back to cited text no. 8
9.Fourth report on the diagnosis, evaluation, and treatment, of high blood pressure in children and adolescents: National High Blood Pressure Education Programme. Working Group on high blood pressure in children and adolescents. Pediatrics 2004;114:555-75.   Back to cited text no. 9
10.Sinaiko AR, Donahue RP, Jacobs Jr DR, Prineas RJ. Relation of weight and rate of increase in weight during childhood and adolescence to body size, blood pressure, fasting insulin, and lipids in young adults. The Minneapolis Children's Blood Pressure Study. Circulation 1999;99:1471-6.  Back to cited text no. 10
11.Mahyar A, Ebrahem M, Shahsavari, Rehman Y. Blood pressure of primary school children of Eghbelich city, Islamic public of Iran. Eastern Mediter. Health J 2009;15.   Back to cited text no. 11
12.Anand NK, Tandon L. Prevalence of hypertension in school going children. Indian Pediatr 1996;33:337-81.  Back to cited text no. 12
13.Prabhjot A, Kaur N, Kumari K, Sidhu S. Variation in blood pressure among school children of Amritsar(Punjab). Anthropologist 2005;7:201-4.  Back to cited text no. 13
14.Patel AB, Sexcena DB, Shah HM. Impact of weight, height and age on blood pressure among school children. Internet J Fam Pract 2009;7.   Back to cited text no. 14
15.Voors AW, Foster PH, Freichs RR, Webber LS, Berenson GS. Studies of blood pressures in children, ages 5-14 years, in a total biracial community. The Bogalusa Heart Study. Circulation 1976;54:319-27.   Back to cited text no. 15
16.Gupta AK, Ahmad AJ. Normal blood pressure and evaluation of sustain blood pressure elevation in childhood. Indian Pediatr 1990;27:33-42.  Back to cited text no. 16
17.Saha I, Raut BK, Paul B. Anthropometric correlate of adolescent blood pressure. Indian J Public Health 2007;51:190-2.  Back to cited text no. 17
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18.Laurer RM, Conner WE, Leaverton PE. Coronary heart disease risk factor in school children: The Muscatine study. J Pediatr 1975;86:697-706.  Back to cited text no. 18


  [Table 1], [Table 2]

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