Prevalence of hypertension and its predictors among adolescent school children in Bikaner, India: a cross-sectional study.

Abstract

Objectives: Non-communicable diseases (NCDs) such as hypertension, obesity, and chronic kidney disease are increasingly recognized among adolescents, particularly in low- and middle-income settings like India, where the epidemiologic transition is well underway. However, robust regional data for semi-urban and rural populations remain sparse. This study assessed the prevalence and determinants of hypertension, obesity, and proteinuria among school-going adolescents in Bikaner, Rajasthan.

Methods: We conducted a cross-sectional study between April 2017 and January 2018 in three randomly selected schools in Bikaner. Adolescents aged 13-19 years were recruited using a multi-stage cluster random sampling technique, with parental consent and participant assent. Standardized anthropometry, blood pressure measurement (AAP 2017 definitions), and dipstick urinalysis for proteinuria/glycosuria were performed. Generalised Mixed Linear models was used to assess predictors of hypertension.

Results: Among 1,082 participants (mean age: 16 ± 2 years; 58.7 % male), the prevalence of overall hypertension was 24.7 %, with an additional 8.3 % exhibiting elevated blood pressure. BMI-based overweight and obesity were observed in 9.3 % and 2.9 %, respectively, while central obesity was present in 49.3 %. Dipstick proteinuria (≥1+) was found in 4.3 %. Multivariable analysis identified age, male sex, central obesity, increasing BMI, and dipstick proteinuria as independent predictors of hypertension. Family history of hypertension, diabetes, and thyroid disease were also associated.

Conclusions: There is a strikingly high prevalence of hypertension and central adiposity among adolescents in this semi-urban population, with early clustering of cardiovascular and renal risk factors. These findings underscore the urgent need for targeted school-based screening and preventive interventions in similar transitional settings across India.