Prevalence of Hypertension among Adolescents in a Rural Area of Madurai District: A Cross-Sectional Study

Essakiraja Kanagasabapathy; Muthurajesh Easwaran; Waseemsha Basha

doi:10.51957/Healthline_763_2026

Authors

Essakiraja Kanagasabapathy Assistant Professor, Institute of Community Medicine, Madurai Medical College, Madurai, Tamil Nadu, India Author https://orcid.org/0009-0002-9071-9950
Muthurajesh Easwaran Associate Professor, Institute of Community Medicine, Madurai Medical College, Madurai, Tamil Nadu, India Author
Waseemsha Shanavaz Basha Assistant Professor, Institute of Community Medicine, Madurai Medical College, Madurai, Tamil Nadu, India Author

DOI:

https://doi.org/10.51957/Healthline_763_2026

Keywords:

Adolescents, Hypertension, Prevalence, Risk Factors

Abstract

Introduction: Hypertension among adults is an important public health problem nowadays. Uncontrolled hypertension leads to certain complications such as chronic kidney diseases, heart failure, stroke, etc. Early screening of children and adolescents helps to identify those “at risk” of developing hypertension at a future date and also modify risk factors at earlier stage thereby preventing complications. Objectives: 1. To estimate the prevalence of hypertension among adolescents aged 10-19 years in Madurai district. 2. To determine the risk factors associated with development of hypertension among the study participants. Methods: A cross-sectional study comprising of 420 adolescents in the age group of 10-19 years in Madurai district were included by cluster sampling. Data was collected using a semi-structured questionnaire. Blood Pressure (BP) was measured and diagnosis of hypertension was made based on guidelines of American Association of Pediatrics and Indian Pediatrics. Results: The present study revealed a prevalence of elevated BP as 2.1% and hypertension as 10.2%. Educational status (p=0.004), screen time (p=0.026) and family history (p=0.000) were significantly associated with adolescent hypertension. There was a positive correlation between Age and Systolic, Diastolic BP and also between Body Mass Index (BMI) and Systolic BP. Conclusion: Based on study findings, around 10.2% of the adolescent population was having hypertension. Non modifiable risk factors like family history of hypertension, age and modifiable risk factors like screen time, BMI were some of the factors associated with hypertension.

References

1. WHO. WHO Health Topics Hypertension [Internet]. Geneva: The Association; c2023 [cited 2023 Feb 13]. Available from: https://www.who.int/health-topics/hypertension

2. WHO. WHO Newsroom Factsheets Detail Hypertension [Internet]. Geneva: The Association; c2023 [cited 2023 Feb 13]. Available from: https://www.who.int/news-room/fact-sheets/detail/hypertension

3. WHO. WHO News More than 700 million people with untreated hypertension [Internet]. Geneva: The Association; c2023 [cited 2023 Feb 13]. Available from: https://www.who.int/news/item/25-08-2021-more-than-700-million-people-with-untreated-hypertension

4. Zhou B, Carrillo-Larco RM, Danaei G, Finucane JC, Gifford B, Gregg EW, et al. Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. Lancet. 2021 Sep 11;398(10304):957-980.

5. National Health Mission. Hypertension Screening, Diagnosis, Assessment, and Management of Primary Hypertension in Adults in India [Internet]. India: Ministry of Health and Family Welfare; c2021 [cited 2023 Feb 13]. Available from: https://nhm.gov.in/images/pdf/guidelines/nrhm-guidelines/stg/Hypertension_full.pdf

6. Song P, Zhang Y, Yu J, Zha M, Zhu Y, Rahimi K, et al. Global prevalence of hypertension in children: a systematic review and meta-analysis. JAMA Pediatr. 2019 Dec 1;173(12):1154-63. DOI: https://doi.org/10.1001/jamapediatrics.2019.3310

7. Daniel RA, Haldar P, Prasad M, Kant S, Krishnan A, Gupta SK, et al. Prevalence of hypertension among adolescents (10-19 years) in India: A systematic review and meta-analysis of cross-sectional studies. PloS one. 2020 Oct 6;15(10):e0239929. DOI: https://doi.org/10.1371/journal.pone.0239929

8. Themes UFO. Hypertension [Internet]. Obgyn Key; 2021 [cited 2023 Feb 13]. Available from: Hypertension | Obgyn Key

9. US Pharmacist. US Pharmacist Cardiovascular Drug Induced Hypertension [Internet]. The Association; c2000 - 2025 [cited 2023 Feb 13]. Available from: https://www.uspharmacist.com/article/drug-induced-hypertension#:~:text=Pharmacists%20should%20maintain%20an%20awareness,products%20(e.g.%2C%20ginseng.

10. Narang R, Saxena A, Desai A, Ramakrishnan S, Thangjam RS, Kulkarni S, et al. Prevalence and determinants of hypertension in apparently healthy schoolchildren in India: A multi-center study. Eur J Prev Cardiol. 2018 Nov;25(16):1775-84. DOI: https://doi.org/10.1177/2047487318790056

11. Sinha A, Saha A, Samuels J. American Academy of Pediatrics clinical practice guidelines for screening and management of high blood pressure in children and adolescents: what is new?. Indian Pediatr. 2019 Apr;56(4):317-321. DOI: https://doi.org/10.1007/s13312-019-1523-5

12. WHO. WHO STEPS Surveillance. Part 3: Training and Practical Guides; Guide to Physical Measurements (Step2). 2008 [Internet]. Geneva: The Association; cWHO 2023 [cited 2023 Feb 13]. Available from: https://www.who.int/docs/default-source/ncds/ncd-surveillance/steps/steps-manual.pdf

13. Swati Y, Sangeeta Y. Normal Adolescent Development. Indian J Pract Pediatr. 2015;17(2):85-89.

14. WHO. WHO Growth reference BMI-for-age (5-19 years) [Internet]. Geneva: The Association; c2023 [cited 2023 Feb 13]. Available from: https://www.who.int/tools/growth-reference-data-for-5to19-years/indicators/bmi-for-age

15. WHO. WHO Health Topics [Internet]. Geneva: The Association; c2023 [cited 2023 Feb 13]. Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight

16. Mahantshetti S, Singh J, Dhandapani S. Updated Modified BG Prasad Classification for October 2023. NJCM. 2024;1(15):89-90. DOI: https://doi.org/10.55489/njcm.150120243515

17. CDC. CDC Sleep [Internet]. USA: Centers for Disease Control and Prevention; 2022 [cited 2022 Nov 21]. Available from: https://www.cdc.gov/sleep/about/index.html#cdc_behavioral_basics_quick-getting-enough-sleep

18. Paruthi S, Brooks LJ, D’Ambrosio C, Hall WA, Kotagal S, Lloyd RM, et al. Recommended amount of sleep for pediatric populations: a consensus statement of the American Academy of Sleep Medicine. J Clin Sleep Med. 2016;12(6):785–786. DOI: https://doi.org/10.5664/jcsm.5866

19. Sukumaran TU. Indian Pediatr. 2011;48:843-844 [Internet]. [cited 2023 Feb 13]. Available from: https://www.indianpediatrics.net/nov2011/nov-843-844.htm DOI: https://doi.org/10.1007/s13312-011-0135-5

20. The Government of the Hong Kong Special Administrative Region. Change4Health - Classification of Physical Activity and Level of Intensity [Internet]. Hong Kong: Department of Health; c2022 [cited 2022 Nov 21]. Available from: https://www.change4health.gov.hk/en/physical_activity/facts/classification/index.html

21. WHO. WHO Physical activity [Internet]. Geneva: The Association; c2023 [cited 202Feb 12]. Available from: https://www.who.int/news-room/fact-sheets/detail/physical-activity

22. WHO. WHO Noncommunicable Disease Surveillance, Monitoring and Reporting Global School based Health Survey Questionnaire [Internet]. Geneva: The Association; c2023 [cited 202Feb 12]. Available from: https://www.who.int/teams/noncommunicable-diseases/surveillance/systems-tools/global-school-based-student-health-survey/questionnaire

23. Gupta P, Shah D, Bedi N, et al. Indian Academy of Pediatrics guidelines on screen time and digital wellness in infants, children and adolescents. Indian Pediatr. 2022;59:235-244. DOI: https://doi.org/10.1007/s13312-022-2477-6

24. Bell CS, Samuel JP, Samuels JA. Prevalence of Hypertension in Children. Hypertension. 2019 Jan;73(1):148-152. DOI: https://doi.org/10.1161/HYPERTENSIONAHA.118.11673

25. Buch N, Goyal JP, Kumar N, Parmar I, Shah VB, Charan J. Prevalence of hypertension in school going children of Surat city, Western India. J Cardiovasc Dis Res. 2011 Oct;2(4):228-32. DOI: https://doi.org/10.4103/0975-3583.89807

26. Nag K, Patra M, Paul A, Saha I, Bhattacharyya K, Dasgupta S, et al. An epidemiological study on prevalence of hypertension and its risk factors among school boys of Burdwan municipal area. Int J Community Med Public Health. 2017 Oct 25;4(11):4213–8. DOI: https://doi.org/10.18203/2394-6040.ijcmph20174831

27. Pandve H. Prevalence of Hypertension and its associated factors among School children in a rural area of Tamil Nadu – a Cross-sectional Study. Int J Med Sci Clin Res Rev. 2021;4(01):6–18. Available from: https://ijmscrr.in/index.php/ijmscrr/article/view/128

28. Kavitha B, Bhuvaneswari K, Vinoth P. Prevalence of sustained hypertension among adolescent school children in Puducherry. Indian J Basic Appl Med Res. 2016 Sep;5(4):649-655.

29. Mohan V, Deepa M, Farooq S, Datta M, Deepa R. Prevalence, awareness and control of hypertension in Chennai--The Chennai Urban Rural Epidemiology Study (CURES-52). J Assoc Physicians India. 2007 May;55:326–32.

30. Chelo D, Mah EM, Chiabi EN, Chiabi A, Koki Ndombo PO, Kingue S, et al. Prevalence and factors associated with hypertension in primary school children, in the centre region of Cameroon. Transl Pediatr. 2019 Dec;8(5):391-397. DOI: https://doi.org/10.21037/tp.2019.03.02

31. Dos Santos EDGS, De Souza OF. Association of Sleep Duration and Blood Pressure in Adolescents: A Multicenter Study. Am J Hypertens. 2020 Jan;33(1):77-83. DOI: https://doi.org/10.1093/ajh/hpz129

32. Dasgupta K, O'Loughlin J, Chen S, Karp I, Paradis G, Tremblay J, et al. Emergence of sex differences in prevalence of high systolic blood pressure: analysis of a longitudinal adolescent cohort. Circulation. 2006 Dec 12;114(24):2663-70. Erratum in: Circulation. 2007 Aug 28;116(9):e319. DOI: https://doi.org/10.1161/CIRCULATIONAHA.106.624536

33. Anchala R, Kannuri NK, Pant H, Khan H, Franco OH, Di Angelantonio E, et al. Hypertension in India: a systematic review and meta-analysis of prevalence, awareness, and control of hypertension. J Hypertens. 2014 Jun;32(6):1170-7. DOI: https://doi.org/10.1097/HJH.0000000000000146

34. Schor J. Coffee and Hypertension [Internet]. Natural Medical Journal; 2017 May 3. Available from: https://www.naturalmedicinejournal.com/journal/coffee-and-hypertension

35. Pardede SO, Yunilasari, Setyanto DB. Prevalence and Factors that Influence Hypertension in Adolescents in Central Jakarta. Am J Clin Med Res. 2017 Jul 7;5(4):43–8.