Prevalence and Predictive Factors of Elevated Blood Pressure and Hypertension in School-Going Children Aged 6 to 12 Years: A SchoolBased Cross-Sectional Study

Abstract

Background: Hypertension in children is an emerging public health concern, particularly in urban India, where lifestyle changes are accelerating its burden. Schools offer an efficient platform for large-scale screening. This study aimed to assess the prevalence and predictive factors of Elevated Blood Pressure and hypertension in school-going children aged 6 to 12 years in Bhopal, Madhya Pradesh. Methods: A multicentre, school-based, cross-sectional observational study was conducted over 18 months (May 2024 to October 2025) under department of Paediatrics of RKDF Medical College Hospital and Research Centre, Bhopal. A total of 225 children aged 6–12 years were enrolled from three government and three private schools using a two-stage random sampling method. Blood pressure was measured by auscultatory method with appropriate cuff sizes; hypertension and Elevated Blood Pressurewere classified using age-, sex-, and height-specific percentiles per AAP 2017 guidelines. Anthropometric measurements, dietary habits, lifestyle behaviours, sleep duration, and family history were recorded through structured questionnaires. Results: Elevated Blood Pressure was observed in 23 children (10.22%): Elevated Blood Pressure in 16 (7.11%), stage 1 hypertension in 6 (2.67%), and stage 2 hypertension in 1 (0.44%). Statistically significant associations were found with age (p = 0.021), socioeconomic status (p = 0.003), BMI category (p = 0.001), school type (p = 0.041), physical activity (p = 0.002), screen time (p < 0.0001), sleep duration (p = 0.004), dietary habits (p < 0.05), and family history of hypertension, diabetes, cardiovascular disease, and renal disease. Renal ultrasonography and Doppler, performed in the 7 children with confirmed hypertension, identified renal abnormalities in 3 children (42.86%), while 4 (57.14%) had normal findings. Conclusion: A notable proportion of school-going children in Bhopal exhibit elevated blood pressure, associated with modifiable lifestyle factors, obesity, higher socioeconomic status, and familial risk. School-based screening and early lifestyle interventions are essential to mitigate the long-term cardiovascular burden in this population.