BACKGROUND In the past two decades, there has been a conceptual change regarding blood pressure measurement in paediatric age group and subsequent development of adult essential hypertension. The routine paediatric blood pressure measurement and its national as well as regional norm publication help us to detect not only fair number of asymptomatic hypertension secondary to formerly undetected disorder but also establishes that mildly elevated blood pressure during childhood were more common than previously recognized particularly in adolescents. Hypertension observed in some children secondary to underlying diseases like renal and endocrine diseases whereas in other cases raised blood pressure may indicate early onset of essential hypertension. Clinically hypertension in children occurs less frequently than in adults but several evidences support that the roots of essential hypertension extends back to early childhood. The awareness of regular blood pressure measurement in paediatric age group was established following publication of first report of the Task Force in Blood Pressure Control on children in 1977. In developed and industrialized country hypertension is a major public health issue involving approximately 20% of adult population compared to paediatric population where the value is 1-3%. The mortality and morbidity related to hypertension are due to atherosclerosis, diabetes, cardiovascular and cerebrovascular diseases and end stage renal disease. There is a rising trend of asymptomatic hypertension among school going children. Keeping this in mind, I have designed this study to find out the prevalence of asymptomatic hypertension among school going children in Kolkata, WB. The objectives of this study were to determine the prevalence of asymptomatic hypertension among school going children between 5-10 years of age, to identify the proper techniques for blood pressure measurement, to prepare distribution curves of blood pressure by age and sex and to recommend blood pressure ranges for children denoting normal, high normal and hypertensive for guarding against inappropriate labelling of hypertensive who are actually not hypertensive. METHODS This is an observational study with cross sectional design done from (n= 1356) OPD of IPGMER & SSKM Hospital, West Bengal and in different schools of Kolkata among school going children between 5-10 years of age. Blood pressure was measured on the cubital fossa kept at heart level in the seated position on three separate occasions after 10 minutes of rest in a controlled environment using mercury manometer by auscultatory method. The mean of each systolic and diastolic measurement was calculated. The cuff size was selected the basis of actual physical built of the child. Sample size was taken for convenience. RESULTS Total 1356 children were taken of which 681 (50.22%) were girls and 675 (49.77%) were boys. Mercury manometer was used to measure blood pressure on three separate occasions at 10 minutes interval in relaxed state. Mean of systolic and diastolic blood pressures were taken for statistical calculation. The overall prevalence of hypertension for systolic and diastolic was 4.12% and 3.88% respectively. In my study I found 3.67% of systolic hypertension (both stage-I and stage-II) and 3.96% of diastolic hypertension (both stage-I and stage-II) out of 681 girls and 4.59% of systolic hypertension and 3.70% of diastolic hypertension out of 675 boys. Percentile distribution of 90th, 95th and 99th and comparison of blood pressure among boys and girls with "p" value were calculated. The overall prevalence of primary and secondary hypertension is 3.68% and 0.44% out of total 1356 observations. CONCLUSIONS In all paediatric examinations including office practice, blood pressure should be measured routinely, and monogram must be available to every doctor to classify a case of hypertension or normotension in accordance with age, gender and height. Blood pressure measurement should also be incorporated in school health programme routinely.
