Risk of High Blood Pressure in Undernourished and overnourished Adolescents from Urban Population in India

The objective of the study was to examine the risks for high blood pressure associated with under nutrition and over nutrition among adolescents, as both forms of malnutrition coexist in India owing to nutritional transition. Adolescents (9-16 yrs) from schools catering to Lower Socio Economic class (LSE; 943 boys, 1000 girls) and High Socio Economic class (HSE; 867 boys, 1042 girls) were measured for weight, height, sitting height, body fat, skin folds and blood pressure. Results revealed that high prevalence of overweight in adolescents from HSE class compared to that in LSE (24.1% vs 2.2% in boys and 20.8% vs 3.9% in girls; p<0.01 for both) indicated risk for High Systolic Blood Pressure (HSBP) while high prevalence of stunting in LSE class (20.8% in boys and 11.8% in girls) indicated risk for High Diastolic Blood Pressure (HDBP). Leg height to height ratio showed significant inverse association with blood pressure levels. In LSE class, prevalence of HDBP was significantly higher than prevalence of HSBP in each quartile of BMI, body fat and skin folds. Increase in systolic blood pressure per unit increase of BMI, was higher in adolescents from LSE class (1.99 mmHg in boys and 1.03 mmHg in girls) compared to those in HSE class (0.91 mmHg in boys and 0.52 mmHg in girls) and this was also true for diastolic blood pressure. Implications of increase in BMI are serious for undernourished children than better nourished children. The observation therefore, underscores the need for planning strategies for preventing adiposity in adolescents from urban as well as rural and poor sections of Indian population.