Prevalence and factors associated with hypertension among children attending pre-schools in Dar es Salaam, Tanzania.

Abstract

Background: Childhood hypertension has become a public health problem due to its increasing prevalence and complications; the high prevalence is noted to mirror an increase in obesity among children. Hypertension in children is frequently undiagnosed due to challenges in getting appropriate cuff sizes and interpretation of the readings. Several studies have been carried out among children however; most of available information is focused on hypertension among older children and adolescents.

Methods: A cross sectional study was conducted in 2 districts of Dar es Salaam region namely Ilala and Kinondoni from October to November 2020. Children aged 2-5 years attending pre-schools in these districts meeting the inclusion criteria and whose parent/guardian signed informed consent were included. Questionnaires were used to collect socio-demographic characteristics; anthropometric and three oscillometric single- occasion blood pressure measurements were taken. The average blood pressure was compared to the standard charts for age and sex provided by the American Academy of Pediatrics 2017 to determine the blood pressure category of the child.

Results: A total of 1083 children fulfilled the eligibility criteria and were enrolled into the study, 51.3% (556/1083) of participants were males and the median age was 4 years (IQR 3-5). Blood pressures for 252 (23.3%) participants were in the high blood pressure range (19.8% with elevated blood pressure and 3.5% with hypertension). No significant gender difference was observed among those with high blood pressure. Factors that were noted to be significantly associated with elevated blood pressure included low birth weight (p = 0.036), increasing age (p = 0.032) and body mass index (p < 0.001).

Conclusion: High prevalence of elevated blood pressure in this population of pre-school aged children is alarming. Low birth weight, increasing age and body mass index were significantly associated with elevated blood pressure.