Hypertension in adolescents in day secondary schools in Kampala: prevalence and associated factors.

Abstract

Background Hypertension is the 3rd leading cause of mortality worldwide. Hypertension in adults has its origin in childhood and adolescence. Hypertension; previously thought to be a problem mostly of adults is fast becoming a problem in adolescents. Studies in both developed and developing countries have shown a high prevalence of Hypertension in children and adolescents associated with many risk factors including modifiable ones such as obesity. The magnitude of the problem in children and adolescents in Uganda is unknown. Against this background, we carried out a study to determine the prevalence and factors associated with hypertension among adolescents in day secondary schools in Makindye division Kampala city. Methods A cross-sectional study carried out in day secondary schools in Makindye division Kampala district. Systematic sampling was used to select the schools and required number of students from the above schools. Self-administered parent questionnaire and interviewer-administered child questionnaire was used to collect data on demographics, medical history and life style related information. Blood pressure, weight and height were measured. Prevalence of Hypertension by demographic characteristics was determined. Linear and logistic regression analysis was used to determine the factors associated with hypertension in these subjects. Findings: A sample of 845 students was selected from 6 day secondary schools in Makindye division. The prevalence of Hypertension was found to be 11.1% (94/845) ( CI 0.08-0.13)among the adolescents studied. There was a predominance of systolic hypertension 10.6 %( 90/845). Of the patients who had hypertension, 67% (60/90) had isolated systolic hypertension. High BMI xii (Overweight and obesity) which was prevalent at 16.4%, was significantly associated with hypertension in this age group and was an independent predictor of hypertension (OR=2.78, CI 1.78-4.69, p-value=0.001) . Use of steroid for more than one month ( OR=2.98, CI. 1.01-8.79, p-value 0.048) and studying in school category 2 and 3 ( OR=2.55, CI.1.13-5.76, p-value 0.023) were also found to independently predict for hypertension . All the other factors were not significantly associated with hypertension. All of the adolescents found to be hypertensive were new diagnoses. There was low awareness about blood pressure status with only 10% of the participants having had their blood pressure measured before. Conclusion: The prevalence of hypertension in the adolescents studied was high at 11.1% and is an emerging public health problem. This problem appears to be more in the adolescents who have high BMI and adolescents on chronic steroid therapy. Child and adolescent public health intervention need to be put in place to control both obesity and hypertension in these children.