Prevalence and lifestyle correlates of adolescent hypertension in North India: a community and hospital-based cross-sectional study

Background: Adolescent hypertension is an emerging public health concern associated with adult cardiovascular morbidity. Data on adolescent blood pressure and its determinants in rural and semi-urban North India remain limited. This study aimed to determine the prevalence of hypertension and assess its socio-demographic, lifestyle, psychosocial, and anthropometric correlates among adolescents in Sitapur, Uttar Pradesh. Methods: A cross-sectional observational study was conducted among 387 adolescents aged 10-19 years. Socio-demographic, dietary, physical activity, and psychosocial data were collected using structured questionnaires. Anthropometric indices using WHO BMI-for-age Z-scores were assessed. Blood pressure (BP) was measured using calibrated oscillometric devices and classified per AAP pediatric guidelines. Statistical analysis was performed using IBM SPSS v26.0, employing Chi-square tests for bivariate analysis. A p-value <0.05 was considered significant. Results: The mean age was 14.48±2.99 years. Overall prevalence of hypertension was 4.9% (19/387), while 9.3% (36/387) exhibited elevated BP. Hypertension occurred exclusively among overweight (9.3%) and obese (24.4%) adolescents (χ2=79.199, p<0.001). Frequent fast-food consumption (p<0.001), daily carbonated drink intake (p<0.001), inadequate physical activity (p<0.001), screen-based sedentary behaviour (p<0.001), tobacco chewing (p<0.001), smoking (p<0.001), positive family history of hypertension (p=0.008), and sleep disturbances (p<0.001) were significantly associated with blood pressure categories. Conclusions: Hypertension and elevated BP pose a notable burden among adolescents in Sitapur. Adiposity, physical inactivity, screen time, unhealthy diet, family history, and sleep disruption were key determinants. School health screenings and lifestyle modification programs are urgently needed.