Prevalence of hypertension in high school children in urban and rural regions of Telangana: a cross-sectional comparative study

Background: Hypertension (HTN) is increasingly recognised as a paediatric concern with significant long-term cardiovascular implications. This study aimed to assess and compare the prevalence of HTN among high school children in the urban and rural settings of Telangana and to identify associated modifiable risk factors. Methods: A cross-sectional, school-based study was conducted from January to December 2025 across four government and four private high schools each in urban (Hyderabad) and rural (Sadasivapet) regions. A total of 1200 students aged 13-15 years were enrolled using multistage random sampling. Data were collected through a pretested structured questionnaire and standardised anthropometric and blood pressure measurements. Statistical analysis was performed using statistical package for the social sciences (SPSS) version 26. Results: The overall prevalence of hypertension was 11.5%. Urban prevalence (14.2%) was significantly higher than rural prevalence (8.2%). A significant association was observed between elevated blood pressure and higher BMI (p<0.01), reduced physical activity (p<0.05), and frequent junk food consumption (p<0.05). Conclusions: Hypertension is a prevalent, under-recognised condition among Telangana adolescents, with a disproportionate urban burden. Preventive strategies targeting modifiable risk factors through school-based screening and health education are warranted.