article · The Italian Journal of Pediatrics/Italian journal of pediatrics
Childhood hypertension is a growing public health concern often linked to rising obesity rates, yet it frequently goes undiagnosed because of difficulties with blood pressure cuff sizing and data interpretation. While previous studies have mostly focused on older children and adolescents, this research examined pre-school children aged two to five years in Dar es Salaam, Tanzania. In a cross-sectional study of 1,083 pre-school attendees across the Ilala and Kinondoni districts, blood pressure and anthropometric measurements were taken alongside questionnaire data. Nearly a quarter of the children, 23.3 percent, recorded blood pressure in the high range, comprising 19.8 percent with elevated blood pressure and 3.5 percent with hypertension. The findings revealed no significant difference between genders, but identified low birth weight, increasing age, and higher body mass index as significant factors linked to elevated blood pressure.
High blood pressure among very young children is frequently overlooked because diagnosis can be technically challenging. By demonstrating that elevated blood pressure is already present in nearly a quarter of pre-schoolers in this urban setting, this work highlights the need to monitor cardiovascular risks earlier in childhood, especially among children with low birth weight or higher body mass index.
The findings highlight an operational need for pediatric blood pressure screening tools tailored to very young children, such as appropriately sized oscillometric cuffs and automated chart-interpretation software for clinical or school settings. This epidemiological research is early-stage observational evidence, so it does not present a commercial product, but it provides justification for healthcare providers and medical device developers to create accessible diagnostic equipment for pre-schools and primary clinics.
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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.
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DOI: 10.1186/s13052-025-01841-y
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