High prevalence of hypertension in normal and underweight Indian children.

Background: Childhood hypertension is an established predictor of adult hypertension and organ damage, an underestimated problem in developing countries. The aim of the study was to assess the prevalence of arterial hypertension, as well as the relationship of blood pressure values and weight class and urinary abnormalities in 1176 children (aged 5-12 years) from a suburban area south of Kolkata, India.

Method: Arterial blood pressure, height, weight and waist circumference were measured. Weight class was defined according to the tables of the International Obesity Task Force. Urinalysis was performed with reagent strips to detect glucosuria, microhematuria and proteinuria.

Results: The majority of children (74.7%) were underweight and 5.2% had systolic and/or diastolic blood pressure values higher or equal to the 95th percentile, according to the National High Blood Pressure Education Program normograms. Hypertension had a high prevalence both in underweight children (4.3%) and in normal-weight children (6.9%) and significantly increased in the rare overweight children (4/20, 20%). A fraction of 8.5% of hypertensive children had urinary abnormalities (microhematuria only) vs. 12.5% in nonhypertensive children (P value 0.36).

Conclusion: Prevalence of hypertension in North-Eastern Indian children is higher than in Western countries and only partly associated to weight class. Causes of hypertension do not seem to be related to overt kidney disease and remain to be elucidated.