Prevalence of Hypertension among Children and Adolescents in India: A Systematic Review and Meta-Analysis

Indian J Pediatr. 2021 Apr 2. doi: 10.1007/s12098-021-03686-9. Online ahead of print.

Abstract

Objective: To conduct a systematic review to provide pooled estimates of the prevalence of hypertension among children aged less than 18 y in India.

Methods: Three electronic databases (PubMed, EMBASE, and Web of Science) were searched from inception to August 2020 by using terms related to hypertension, children, prevalence, and India. Studies reporting the prevalence of hypertension, defined based on at least three measurements, were included. Two investigators independently performed the literature search, study selection, and data extraction for this review. Random effect meta-analysis was used to provide pooled estimates of hypertension.

Results: A total of 64 studies were included in this systematic review. The pooled prevalence was 7% (95% CI: 6%-8%) for hypertension, 4% (95% CI: 3%-4.1%) for sustained hypertension and 10% (95% CI: 8%-13%) for prehypertension. While there was no significant difference in hypertension across five different regions of the country, an upward rising trend was observed after the year 2005. Urban children had a higher prevalence of hypertension as compared to their rural counterparts. Children with obesity had a significantly high prevalence of hypertension (29%) than normal-weight children (7%).

Conclusion: In this review, it was observed that considerable proportions (7%) of school going children are hypertensive in India. Prevalence was higher in urban and overweight children. This study highlights that hypertension is a public health problem in India; hence, there is a need to implement public health measures to prevent hypertension.

Keywords: Elevated blood pressure; India; Obesity; Pediatrics; Sustained hypertension.