Skip to main content
SpringerLink
Log in

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

  • Original Article
  • Published:
Indian Journal of Pediatrics Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Global health estimates. 2016: Disease burden and mortality estimates: cause-specific mortality, 2000–2016. Geneva: World Health Organization; 2018. https://www.who.int/healthinfo/global_burden_disease/estimates/en.

  2. GBD 2016 Risk Factors Collaborators. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1345–422. https://doi.org/10.1016/s0140-6736(17)32366-8.

  3. Geldsetzer P, Manne-Goehler J, Theilmann M, et al. Diabetes and hypertension in India: a nationally representative study of 1.3 million adults. JAMA Intern Med. 2018;178:363–72.

    Article  Google Scholar 

  4. Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet. 2005;365:217–23.

    Article  Google Scholar 

  5. Anchala R, Kannuri NK, Pant H, et al. Hypertension in India: a systematic review and meta-analysis of prevalence, awareness, and control of hypertension. J Hypertens. 2014;32:1170–7.

    Article  CAS  Google Scholar 

  6. Bao W, Threefoot SA, Srinivasan SR, Berenson GS. Essential hypertension predicted by tracking of elevated blood pressure from childhood to adulthood: the Bogalusa heart study. Am J Hypertens. 1995;8:657–65.

    Article  CAS  Google Scholar 

  7. Flynn JT, Kaelber DC, Baker-Smith CM, et al. Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics. 2017;140:e20171904.

    Article  Google Scholar 

  8. Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6:e1000097.

    Article  Google Scholar 

  9. Hoy D, Brooks P, Woolf A, et al. Assessing risk of bias in prevalence studies: modification of an existing tool and evidence of interrater agreement. J Clin Epidemiol. 2012;65:934–9.

    Article  Google Scholar 

  10. Barendregt JJ, Doi SA, Lee YY, Norman RE, Vos T. Meta-analysis of prevalence. J Epidemiol Community Health. 2013;67:974–8.

    Article  Google Scholar 

  11. Patel A, Bharani A, Sharma M, Bhagwat A, Ganguli N, Chouhan D. Prevalence of hypertension and prehypertension in schoolchildren from Central India. Ann Pediatr Cardiol. 2019;12:90.

    Article  Google Scholar 

  12. Dyson PA, Anthony D, Fenton B, Matthews DR, Stevens DE. High rates of child hypertension associated with obesity: a community survey in China, India and Mexico. Paediatr Int Child Health. 2014;34:43–9.

    Article  Google Scholar 

  13. Chaudhury AR, Reddy TV, Divyaveer SS, et al. A cross-sectional prospective study of asymptomatic urinary abnormalities, blood pressure, and body mass index in healthy school children. Kidney Int Rep. 2017;2:1169–75.

    Article  Google Scholar 

  14. McCarron P, Smith GD, Okasha M. Secular changes in blood pressure in childhood, adolescence and young adulthood: systematic review of trends from 1948 to 1998. J Hum Hypertens. 2002;16:677–89.

    Article  CAS  Google Scholar 

  15. Roy S, Ghosh JR. Hypertension in Asian Indian children and adolescents: a systematic review on the prevalence and associated risk factors. J Life Sci. 2017;9:55–63.

    Article  Google Scholar 

  16. Song P, Zhang Y, Yu J, et al. Global prevalence of hypertension in children: a systematic review and meta-analysis. JAMA Pediatr. 2019;173(12):1–10.

    Article  Google Scholar 

  17. Wang L, Song L, Liu B, et al. Trends and status of the prevalence of elevated blood pressure in children and adolescents in China: a systematic review and meta-analysis. Curr Hypertens Rep. 2019;21:88.

    Article  Google Scholar 

  18. Noubiap JJ, Essouma M, Bigna JJ, Jingi AM, Aminde LN, Nansseu JR. Prevalence of elevated blood pressure in children and adolescents in Africa: a systematic review and meta-analysis. Lancet Public Health. 2017;2:e375–86.

    Article  Google Scholar 

  19. Daniel RA, Haldar P, Prasad M, 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;15:e0239929.

    Article  CAS  Google Scholar 

  20. Gonçalves VSS, Galvão TF, de Andrade KRC, et al. Prevalence of hypertension among adolescents: systematic review and meta-analysis. Rev Saude Publica. 2016;50:27.

    Article  Google Scholar 

  21. Nayak BS, D’souza A, Shetty S, Ravishankar N. Prevalence of childhood hypertension in South Asia: a systematic review and meta-analysis. J Clin Diagn Res. 2018;12(10):LC13–8. https://doi.org/10.7860/JCDR/2018/36400.12200.

    Article  Google Scholar 

  22. Sorof J, Daniels S. Obesity hypertension in children: a problem of epidemic proportions. Hypertension. 2002;40:441–7.

    Article  CAS  Google Scholar 

  23. Acosta AA, Samuels JA, Portman RJ, Redwine KM. Prevalence of persistent prehypertension in adolescents. J Pediatr. 2012;160:757–61.

    Article  Google Scholar 

  24. Ranjani H, Mehreen TS, Pradeepa R, et al. Epidemiology of childhood overweight & obesity in India: a systematic review. Indian J Med Res. 2016;143:160–74.

    Article  CAS  Google Scholar 

  25. Shankar RR, Eckert GJ, Saha C, Tu W, Pratt JH. The change in blood pressure during pubertal growth. J Clin Endocrinol Metab. 2005;90:163–7.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. ICMR Advanced Center for Evidence-Based Child Health, Department of Pediatrics, Advanced Pediatric Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India

    Jitendra Meena, Meenu Singh, Amit Agarwal, Anil Chauhan & Nishant Jaiswal

Authors
  1. Jitendra Meena
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Meenu Singh
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Amit Agarwal
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Anil Chauhan
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Nishant Jaiswal
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

JM had full access to all the data in the study and takes responsibility for thethe integrity of the data and the accuracy of the data analysis. JM, MS: Concept and design; JM, AA, AC, NJ: Acquisition, analysis, or interpretation of data; JM: Drafting of the manuscript; JM, AA, NJ, MS: Critical revision of the manuscript for important intellectual content. JM will act as guarantor for this paper.

Corresponding author

Correspondence to Jitendra Meena.

Ethics declarations

Conflict of Interest

None.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

ESM 1

(DOCX 75.8 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Meena, J., Singh, M., Agarwal, A. et al. Prevalence of Hypertension among Children and Adolescents in India: A Systematic Review and Meta-Analysis. Indian J Pediatr 88, 1107–1114 (2021). https://doi.org/10.1007/s12098-021-03686-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12098-021-03686-9

Keywords

Search

Navigation