A Study of Prevalence of Obesity and Hypertension Among Children and Adolescents in North-West Rajasthan
A Study of Prevalence of Obesity and Hypertension Among Children and Adolescents in North-West Rajasthan
A Study of Prevalence of Obesity and Hypertension Among Children and Adolescents in North-West Rajasthan
*Corresponding Author:
Dr. Shivam Sethi
Department of Medicine, Sardar Patel Medical College, Bikaner, Rajasthan, India
being seen in developing countries also7, 8. The children are either overweight or obese11.
problem attains a greater magnitude in developing
International Journal of Medical Science and Current Research | September-October 2020 | Vol 3 | Issue 5
Dr. Shivam Sethi et al International Journal of Medical Science and Current Research (IJMSCR)
Rapid changes in the prevalence of childhood obesity Blood pressure was measured using mercury
in recent decades within a relatively stable population sphygmomanometer in right arm in sitting
indicate that genetic factors are not the primary position by ascultatory method. The
cause. Therefore, changes in the nature of the individual was made comfortable and seated
environment towards a more obesogenic society are at least for five minutes in the chair before
the most likely cause for the rise in prevalence12. measurement. Those participants who had
raised blood pressure were checked again half
70% Children with obesity have at least one
an hour apart and the average of two reading
cardiovascular risk factor, and 39% have ≥2. These
was taken.
risk factors, along with obesity, are associated with
heart disease in childhood and more importantly, According to recent guidelines by American
track into increased risk of atherosclerosis and left College of Cardiology and American Heart
ventricular hypertrophy in adulthood.13 Association 2017, participants having systolic
blood pressure (SBP) <120mmHg and
AIMS AND OBJECTIVES
diastolic blood pressure (DBP) <80mm Hg
1. To study the prevalence of overweight and were considered as normal, those with SBP
obesity in children and adolescents in North- between 120-129 mmHg and DBP <80mmHg
West Rajasthan were considered as having elevated blood
2. To study the prevalence of hypertension in pressure, those having SBP between 130-139
children and adolescents in North-West mmHg or DBP between 80-89mmHg as stage
Rajasthan. 1 hypertensive while those with SBP≥ 140
mmHg or DBP≥ 90 mmHg as stage 2
3. To study prevalence of hypertension in hypertensive.
accordance to BMI
Body weight was measured to the nearest
MATERIAL & METHODS 0.1kg using a digital weighing machine with
This study was conducted in the Department subjects barefoot.
of Medicine, S.P. Medical College and associated Body height was measured using calibrated
group of Hospitals, Bikaner. A sample size of 1000 stadiometer to the nearest mm with subjects
apparently healthy children and adolescents from 10- barefoot.
18 years of age of both genders were taken from
various schools of Bikaner district. Body mass index (BMI) was measured as the
ratio of body weight to body height squared,
INCLUSION CRITERIA expressed as kg/m2.
A. Age - 10-18 years Revised IAP growth chart for BMI
B. Diagnostic criteria for overweight and formulated by Khadilkar et al14 is used.
obesity- Values corresponding to 23 and 27 adult
equivalent percentiles were taken as
Revised IAP growth chart for BMI is overweight and obesity cutoff whereas value
used14 and values equivalent to adult corresponding to less than 3 percentile was
BMI 23kg/m2 and 27kg/m2 were taken considered as underweight.
as overweight and obesity cut-off.
Statistical analysis was done using SPSS 17.0
EXCLUSION CRITERIA software. Chi Square test was applied. P value
A. Subject with thyroid dysfunction <0.05 was considered as significant.
B. Secondary causes of obesity OBSERVATION AND RESULTS
C. Any acute or chronic illness In our study, we found that 61 candidates (6.1%)
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There are very few studies conducted in Rajasthan. of hypertension in normal weight as well as obese
One of the studies by Jain et al17 in 2012 in Jaipur, can be attributed to lower cut-off values in recent
showed the prevalence of overweight to be 12.5% guidelines and also due to changing lifestyle. We also
and that of obesity 5.6%. Another study by found positive correlation between systolic BP
Choudhary et al18 in 2017 in Jaipur, showed the (r=0.198, p<0.001) and diastolic BP (r=0.193,
prevalence of overweight to be 32.65% in males and p<0.001) with BMI. Many other studies have also
34.15% in females. They also found that 33.67% shown similar results22, 23, 24. In a study done in 2009-
males and 32.93% females belonged to the obese 10 by Kar and Khandelwal25 in adolescent in Sikkim,
category. The high prevalence of obesity and a positive linear relationship was found between
overweight in their study can be attributed to very systolic and diastolic BP and BMI. Danasekaran et
small sample size of 180 candidates. al26 found the prevalence of hypertension among
obese to be 25% in contrast to 4.4% among those
Continuous rising trend of the problem can be
with normal BMI. This shows that apart from BMI
attributed to sedentary life style, increase
there are many other factors like family history,
consumption of junk food, decrease physical activity
genetic makeup, high sodium diet, lack of exercise
and more stress of studies.
etc. which may contribute to high blood pressure.
Prevalence of hypertension
CONCLUSION
In our study, we analysed the prevalence of
Prevalence of obesity is increasing in children and
hypertension according to the recent guidelines
adolescents across the country including north -west
published by American College of Cardiology and
Rajasthan. As obesity is increasing in children and
American Heart Association in 2017.
adolescents of our society, therefore the incidence of
We found that 145 (14.5%) candidates had elevated elevated blood pressure and hypertension is also
blood pressure, 147 (14.7%) were hypertensive, out increasing among children and adolescents. However,
of which 107 (10.7%) had hypertension stage 1, apart from BMI there are many other factors like
while 40 (4.0%) had hypertension stage 2. 708 family history, genetic makeup, high sodium diet,
Candidates (70.8%) had normal blood pressure. lack of exercise etc. which may contribute to high
In 2011 Buch et al19 reported the prevalence of blood pressure among them.
hypertension to be 6.48% among school going Based on observations of our study, it is
children of Surat. In 2013, study done by Anand et recommended that strategies for obesity prevention,
al20 among adolescents in Delhi showed the weight reduction, promotion of healthy lifestyles and
prevalence of pre-hypertension 30.1% while that of regular monitoring are necessary during childhood
hypertension 7%. and adolescence else the implications of this global
In a large retrospective study in USA by Dr Parker at phenomenon on future generations will be serious.
el. 21 , including more than 100,000 children (age 3– LIMITATIONS
11 years) and adolescents (age 12–17 years),, those
As the sample size was small, the prevalence
with obesity and severe obesity developed higher
obtained may not be truly reflective of the
systolic blood pressure and diastolic blood pressure ,
heterogeneity in the population. Larger sample size is
when followed over a course of several years.
required to obtain a better and more representative
Our study shows that, not only overweight and obese, overview of prevalence of obesity and hypertension
but also normal BMI candidates were at risk of in children and adolescents in north-west region of
developing hypertension. The increased prevalence Rajasthan.
377
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Table 1
Prevalence and gender wise distribution of underweight, overweight and obesity among study subjects
Sex BMI Group Total
Under Normal Over weight Obese
weight
No. % No. % No. % No. % No. %
Female 33 54.1 286 39.2 51 37.0 16 22.2 386 38.6
Male 28 45.9 443 60.8 87 63.0 56 77.8 614 61.4
Total 61 100 729 100 138 100 72 100 1000 100
2
6.5839 0.4531 0.1825 8.7809
P <0.05 >0.05 >0.05 <0.01
Table 2
Prevalence of hypertension among study subjects
Blood pressure Number of subjects Percentage (%)
Normal 708 70.8
Elevated 145 14.5
HTN1 107 10.7
HTN2 40 4.0
Total 1000 100.0
Table 3
Gender wise distribution of blood pressure
Sex Hypertension Group Total
Normal Elevated HTN1 HTN2
No. % No. % No. % No. % No. %
Female 312 80.8 31 8.0 31 8.0 12 3.1 386 38.6
Male 396 64.5 114 18.6 76 12.4 28 4.6 614 61.4
Total 708 70.8 145 14.5 107 10.7 40 4.0 1000 100
2 24.7896 9.8454 0.8570
P <0.001 <0.01 >0.05
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Table 4
Distribution of cases according to BMI categories in relation to hypertension
BMI Total Hypertension status
Normal Elevated HTN1 HTN2
No. % No. % No. % No. %
Under 61 56 91.8 2 3.2 3 4.9 0 -
weight
Normal 729 535 73.4 116 15.9 65 8.9 13 1.7
Over 138 83 60.14 19 13.8 25 18.1 11 8
weight
Obese 72 34 47.2 8 11.11 14 19.4 16 22.2
Total 1000 708 70.8 145 14.5 107 10.7 40 4
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