Document Type : Research Article (s)


1 Department of Community Medicine, Murshidabad Medical College, West Bengal, India

2 Department of Paediatrics, R.G. Kar Medical College, Kolkata, West Bengal, India

3 Tamralipto Government Medical College and Hospital, Tamluk, Purba Medinipur, West Bengal, India


Background: The prevalence of adolescent hypertension is on the rise due to multiplicity of certain risk factors, like obesity, unhealthy dietary behaviour, physical inactivity, tobacco use, alcohol addiction, and academic stress. The present study aimed to estimate the prevalence of elevated blood pressure and hypertension among adolescent school children and identify the factors influencing it.
Methods: The present observational, cross-sectional study was conducted in two higher secondary schools in a block of Murshidabad district, West Bengal, from February to April 2021. The subjects included 15 to 19-year-old school students. Multistage random sampling method was used for selecting a sample size of 183 adolescent school children. Data were obtained by interviewing the study participants, measurement of blood pressure and anthropometric measurements. Chi-squared test and binary logistic regression were used for bivariate and Multivariable data analysis, respectively, with P<0.05 as the level of significance.
Results: The mean of Systolic Blood Pressure and Diastolic Blood Pressure were 115.02+10.853 and 71.52+8.484 mm of Hg, respectively. The overall prevalence of elevated blood pressure and adolescent hypertension was 21.3% (95% CI 15.4-27.2). The prevalence was significantly higher among those with paternal education of above middle school (AOR=1.803, P=0.011), high socioeconomic status (AOR=3.16, P=0.02), and high Body Mass Index for their age (AOR=11.474, P<0.0001). Smart phone use (P=0.03) and family history of hypertension (P=0.029) were also found to significantly influence elevated blood pressure among the subjects in bivariate analysis.
Conclusions: Measurement of blood pressure, as a part of school health programme, should be given priority with emphasis on physical activity at school, health promotion to avoid unhealthy diet, and restricted smart phone use.


How to Cite: Sarkar A, Ghosh R, Mondal S, Mallik S. Magnitude and Correlates of Elevated Blood Pressure among Adolescent School Students Aged 15- 19 Years in a Block of Murshidabad, West Bengal, India. Int. J. School. Health. 2023;10(1):3-11. doi: 10.30476/INTJSH.2023.96967.1262.


1. World Health Organization. Geneva 2013. Global Brief on Hypertension Silent killer, global public health crisis. Available from: on 13.1.20. ## 2. Satyanarayan K, Kandhi P, Pereira KR. Study of prevalence and determinants of hypertension among the urban school going children aged 10-15 years . Ann Trop Med Public Health 2016:9:421-4. ## 3. Ghosh R, Maulik S, De S, Tikader T, Jha SN, Mondal S, et al. Strengthening opportunistic screening for hypertension: report from a tertiary care institution in a district of West Bengal, India. International Journal of Community Medicine and Public Health. 2019;6(9):3878-85. doi: 10.18203/2394-6040.ijcmph20193987. ## 4. Gonçalves VS, Galvão TF, de Andrade KRC, Dutra ES, Bertolin MNT, de Carvalho KMB, et al. Prevalence of hypertension among adolescents: systematic review and meta-analysis. Rev Saude Publica. 2016;50:27. doi: 10.1590/S1518-8787.2016050006236. PubMed PMID: 27253903; PubMed Central PMCID: PMC4902100. ## 5. Kumar P, Kumar D, Ranjan A, Singh CM, Pandey S, Agarwal N. Prevalence of Hypertension and its Risk Factors Among School Going Adolescents of Patna, India. J Clin Diagn Res. 2017;11(1):SC01–SC04. doi:10.7860/JCDR/2017/23886.9196. PubMed PMID: 28274012; PubMed Central PMCID: PMC5324457. ## 6. Mahajan A, Negi PC. Hypertension and pre-hypertension among adolescents in Shimla, Northern India-Time to awaken. Nig J Cardiol. 2015;12:71-6. doi: 10.4103/0189-7969.152008. ## 7. Prasad S, Masood J, Srivastava AK, Mishra P. Elevated blood pressure and its associated risk factors among adolescents of a North Indian City - A cross-sectional study. Indian J Community Med. 2017;42(3):155-158. doi: 10.4103/ijcm.IJCM_106_16. PubMed PMID: 28852279; PubMed Central PMCID: PMC5561693. ## 8. 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;15(10):e0239929. doi: 10.1371/journal.pone.0239929. PubMed PMID: 33022021; PubMed Central PMCID: PMC7537899. ## 9. Gupta A, Sarker G, Das P, Shahnawaz K, Pal R. Prevalence of lifestyle associated cardiovascular risk factors among adolescent students of Rural Bengal. J Integr Health Sci. 2013;1:69-75. doi: 10.4103/2347-6486.239497. ## 10. International Institute for Population Sciences (IIPS) and ICF. National Family Health Survey (NFHS-4); 2015-16: India. Mumbai: IIPS. ## 11. Sinha R, Saha Abhijeet, 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;56(4):317-321. PubMed PMID: 31064903. ## 12. Maiti M, Bandyopadhyay L. Variation in blood pressure among adolescent schoolchildren in an urban slum of Kolkata, West Bengal. Postgrad Med J. 2017;93(1105):648-652. doi: 10.1136/postgradmedj-2016-134227. PubMed PMID: 27458067. ## 13. Nag K, Karmakar N, Saha I, Dasgupta S, Mukhopadhyay BP, Islam Mondal MR. An epidemiological study of blood pressure and its relation with anthropometric measurements among schoolboys of Burdwan Municipal Area, West Bengal. Indian J Community Med. 2018;43(3):157-160. doi: 10.4103/ijcm.IJCM_232_17. PubMed PMID: 30294079; PubMed Central PMCID: PMC6166502. ## 14. Das Gupta A, Sarkar D, Paul B, Ghosh P, Biswas A, Ghose SD, et al. A Study on Variation of Blood Pressure and Associated factors among Adolescent school students in North 24 Parganas, west Bengal, India. Journal of Clinical and Diagnostic Research. 2020;14(10):LC06-LC10. doi: 10.7860/JCDR/2020/44574.14145. ## 15. Gidding SS, Whelton PK, Carey RM, Flynn J, Kaelber DC, Smith CB. Aligning Adult and Pediatric Blood Pressure Guidelines. Hypertension. 2019;73(5):938-943. doi: 10.1161/HYPERTENSIONAHA.119.12653. PubMed PMID: 30929515. ## 16. Bell K, Twiggs J, Olin BR. Hypertension: The Silent Killer: Updated JNC-8 Guideline Recommendations; 2015. Available from: ## 17. Debnath DJ. Kakkar R. Modified BG Prasad Socio-economic Classification, Updated – 2020. Indian Journal of Community Health. 2020;32(1):124-125. doi: 10.47203/IJCH.2020.v32i01.024. ## 18. Chaput JP, Willumsen J, Bull F, Chou R, Ekelund U, Firth J, et al. 2020 WHO guidelines on physical activity and sedentary behaviour for children and adolescents aged 5–17 years: summary of the evidence. Int J Behav Nutr Phys Act. 2020;17(1):141. doi: 10.1186/s12966-020-01037-z. PubMed PMID: 33239009; PubMed Central PMCID: PMC7691077. ## 19. WHO. Geneva. 2021 BMI-for-age (5-19 years) z scores for boys and girls. Available from: ## 20. Yadav S, Arokiasamy P. Understanding epidemiological transition in India. Glob Health Action. 2014;7:23248. doi: 10.3402/gha.v7.23248. PubMed PMID: 24848651; PubMed Central PMCID: PMC4028906. ## 21. Prasad S, Longkumer I, Saraswathy KN. Prevalence of Hypertension and Adiposity Indicators Among Children and Adolescents of Meghwal Community: A Cross-sectional Study from Udaipur, Rajasthan (India). The Oriental Anthropologist. 2021;21(1):104-115. doi: 10.1177/0972558X209752. ## 22. Anand T, Ingle GK, Meena GS, Kishore J, Kumar R. Hypertension and its correlates among school adolescents in Delhi. Int J Prev Med. 2014 Mar;5(Suppl 1):S65-S70. PubMed PMID: 24791194; PubMed Central PMCID: PMC3990918. ## 23. Patel A, Bharani A, Sharma M, Bhagwat A, Ganguli N, Chouhan DS. Prevalence of hypertension and prehypertension in schoolchildren from Central India. Ann Pediatr Cardiol. 2019;12(2):90-96. PubMed PMID: 31143032; PubMed Central PMID: 31143032. ## 24. Mohan B, Verma A, Singh K, Singh K, Sharma S, Bansal R, et al. Prevalence of sustained hypertension and obesity among urban and rural adolescents: a school-based, cross-sectional study in North India. BMJ Open. 2019;9(9):e027134. doi: 10.1136/bmjopen-2018-027134. PubMed PMID: 31501100; PubMed Central PMCID: PMC6738741. ## 25. Patil RR, Garg BS. Prevalence of hypertension and variation in blood pressure among school children in rural area of Wardha. Indian J Public Health. 2014;58(2):78-83. doi: 10.4103/0019-557X.132278. PubMed PMID: 24820979. ## 26. Okagua J, Akani N. Prevalence of Hypertension in School going Adolescents in Rural areas of Rivers State, South-South Nigeria. The Nigerian Health Journal. 2014;(4):157. ## 27. Ravi R, Vineetha R. Prevalence of Obesity and Hypertension among Rural School Adolescents: A School Based Pilot Study in Kerala, India. Journal of Pharmaceutical Research International. 2021;6-12. doi: 10.9734/jpri/2021/v33i42B32420. ## 28. Kumar J, Deshmukh PR, Garg BS. Prevalence and correlates of sustained hypertension in adolescents of rural Wardha, central India. Indian J Pediatr. 2012;79(9):1206-12. doi: 10.1007/s12098-011-0663-y. PubMed PMID: 22203427. ## 29. RoyChoudhury S, Nayek K, Saha J. A Study on Burden of Prehypertension in Youth (or Pediatric Hypertension) in West Bengal, India. Journal of Child Science. 2021;11(01):e273-e279. doi: 10.1055/s-0041-1736240. ## 30. Riley M, Hernandez AK, Kuznia AL. High Blood Pressure in Children and Adolescents. Am Fa Physician. 2018;98(8):486-494. PubMed PMID: 30277729. ## 31. MadhavikuttyAmma GD, Vasudevan B, Akshayakumar S. Prevalence and determinants of prehypertension and hypertension among adolescents: a school based study in a rural area of Kerala, India. Int J Res Med Sci. 2015;3:58-64. ## 32. Kaczmarek M, Stawińska-Witoszyńska B, Krzyżaniak A, Krzywińska-Wiewiorowska M, Siwińska A. Who is at higher risk of hypertension? Socioeconomic status differences in blood pressure among Polish adolescents: a population-based ADOPOLNOR study. Eur J Pediatr. 2015;174(11):1461-1473. doi: 10.1007/s00431-015-2554-0. PubMed PMID: 25956273; PubMed Central PMCID: PMC4623093. ## 33. Sabri M, Gheissari A, Mansourian M, Mohammadifard N, Sarrafzadegan N. Essential hypertension in children, a growing worldwide problem. J Res Med Sci. 2019;24:109. doi: 10.4103/jrms.JRMS_641_19. PubMed PMID: 31949460; PubMed Central PMCID: PMC6950331. ## 34. Jamir L, Duggal M, Nehra R, Singh P, Grover S. Epidemiology of technology addiction among school students in rural India. Asian J Psychiatr. 2019;40:30-38. doi: 10.1016/j.ajp.2019.01.009. PubMed PMID: 30716701. ## 35. Zou Y, Xia N, Zou Y, Chen Z, Wen Y. Smartphone addiction may be associated with adolescent hypertension: a cross-sectional study among junior school students in China. BMC Pediatrics. 2019;19:310. ## 36. Guo X, Zheng L, Li Y, Yu S, Liu S, Zhou X, et al. Association between sleep duration and hypertension among Chinese children and adolescents. Clin Cardiol. 2011;34(12):774-781. doi: 10.1002/clc.20976. PubMed PMID: 21997181; PubMed Central PMCID: PMC6652439. ## 37. Kuciene R, Dulskiene V. Associations of short sleep duration with prehypertension and hypertension among Lithuanian children and adolescents: a cross-sectional study. BMC Public Health. 2014;14:255. doi: 10.1186/1471-2458-14-255. PubMed PMID: 24628980; PubMed Central PMCID: PMC3984754. ##