The burden of hypertension in future doctors: a phase-wise cross-sectional study
DOI:
https://doi.org/10.18203/2320-6012.ijrms20250667Keywords:
Hypertension, Systolic BP, Diastolic BP, Medical studentsAbstract
Background: Hypertension is a growing concern in young adults, yet most studies focus on the elderly. Investigating its prevalence and risk factors in younger populations can enable timely interventions to prevent long-term complications. Medical students, facing academic stress and lifestyle changes, are particularly vulnerable. This study assessed hypertension prevalence and blood pressure variations across four academic phases.
Methods: A cross-sectional analytic study was conducted among 499 medical students aged 18–27 from four academic phases. Participants were selected through multi-stage sampling, and demographic, anthropometric, and clinical data were collected. Blood pressure was measured using an Omron HBP-1320 device, validated per ANSI/AAMI/ISO and ESH IP2 protocols, with classification based on AHA guidelines. Statistical analyses included ANOVA, chi-squared tests, and Spearman’s correlation.
Results: Median age increased from 20 years in phase 1 to 23 in phase 4. Mean BMI rose from 22.07±4.01 kg/m² to 23.51±4.67 kg/m². Systolic blood pressure increased across phases but was not statistically significant (p=0.223). Diastolic pressure rose significantly (p=0.011), with hypertension prevalence escalating from 19.5% to 41.2%. Males exhibited higher SBP, DBP, and pulse pressure (p<0.001). Positive correlations were observed between age, BMI, and blood pressure.
Conclusion: The study highlights a rising trend in stage 1 hypertension and diastolic pressure with academic progression, likely due to stress and lifestyle changes. Males had higher blood pressure levels. Early interventions targeting modifiable risk factors are essential to prevent long-term complications.
Metrics
References
World Heart Federation. Available at: https://world-heart-federation.org. Accessed on 21 September 2024.
Anchala R, Kannuri NK, Pant H, Khan H, Franco OH, Di Angelantonio E, et. Hypertension in India: a systematic review and meta-analysis of prevalence, awareness, and control of hypertension. J Hypertens. 2014;32(6):1170-7. DOI: https://doi.org/10.1097/HJH.0000000000000146
World Health Organization. Geneva, Switzerland: WHO; 2013. Controlling the global obesity epidemic. Nutrition health topics. Available at: http://www.who.int/nutrition. Accessed on 18 November 2024.
Boutari C, Mantzoros CS. A 2022 update on the epidemiology of obesity and a call to action: as its twin COVID-19 pandemic appears to be receding, the obesity and dysmetabolism pandemic continues to rage on. Metabolism. 2022;133:155217. DOI: https://doi.org/10.1016/j.metabol.2022.155217
Pradeepa R, Anjana RM, Joshi SR, Bhansali A, Deepa M, Joshi PP, et al. ICMR-INDIAB collaborative study group. Prevalence of generalized & abdominal obesity in urban & rural India—The ICMR-INDIAB Study (Phase-I) ICMR- NDIAB-3. Indian J Med Res. 2015;142:139-50. DOI: https://doi.org/10.4103/0971-5916.164234
Thomas UM, Narayan Appa D, Sujatha MS. Prevalence of overweight and obesity among school children in Mysuru, Karnataka. J Family Med Prim Care. 2021;10:2788-92. DOI: https://doi.org/10.4103/jfmpc.jfmpc_2334_20
Gopalakrishnan S, Ganesh KP, Prakash MV, Christopher, Amalraj V. Prevalence of overweight/obesity among medical students, Malaysia. Med J Malaysia. 2012;67:442–4.
Srinivasan K, Vaz M, Sucharita S. A study of stress and autonomic nervous function in first-year undergraduate medical students. Indian J Physiol Pharmacol. 2006;50:257–64.
Wolf G. Free radical production and angiotensin. Curr Hypertens Rep. 2000;2:67–73. DOI: https://doi.org/10.1007/s11906-000-0078-z
Fernandez K, Singru SA, Kshirsagar M, Pathan Y. Study regarding overweight/obesity among medical students of a teaching hospital in Pune, India. Med J DY Patil Univ. 2014;7:279–83. DOI: https://doi.org/10.4103/0975-2870.128950
Dantu P, Ujwala U. Influence of certain factors on overweight and obesity among undergraduate medical students at Vizianagaram. Int J Recent Trends Sci Technol. 2012;5:38–42.
Singh A, Purohit B. Physical activity, sedentary lifestyle and obesity among Indian dental professionals. J Phys Act Health. 2012;9:563–70. DOI: https://doi.org/10.1123/jpah.9.4.563
Lohitashwa R, Patil P. A cross-sectional study of the relationship of obesity indices, with blood pressure and blood glucose level in young adult medical students. Int J Basic Med Sci 2012; 3:102–7.
Khaliq F, Gupta K, Singh P. Stress, autonomic reactivity and blood pressure among undergraduate medical students. J Nepal Med Assoc 2010; 49:14–8. DOI: https://doi.org/10.31729/jnma.125
World Health Organization. The WHO STEPS surveillance manual. Available at: http://new.paho. Accessed on 18 November 2022.
Ogedegbe G, Pickering T. Principles and techniques of blood pressure measurement. Cardiol Clin. 2010;28(4):571-86. DOI: https://doi.org/10.1016/j.ccl.2010.07.006
Saito K, Hishiki Y, Takahashi H. Validation of the Omron HBP-1320 for professional use according to the ANSI/AAMI/ISO 81060-2: 2013 protocol and the 2010 revision of the European Society of Hypertension International Protocol. Blood Press Monit. 2020;25(3):162-6. DOI: https://doi.org/10.1097/MBP.0000000000000437
Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Dennison Himmelfarb C, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American heart association task force on clinical practice guidelines. J of the American College of Cardiol. 2018;71(19):127-248. DOI: https://doi.org/10.1161/HYP.0000000000000076
Nwoke OO, Nkoyo, I., Nubila., Onyekachi, Ezekiel, Ekowo., Nwabunwanne, C, Nwoke., Edwin, N., Okafor., Raphael, Anakwue. Prevalence of Prehypertension, Hypertension, and its Determinants Among Young Adults in Enugu State, Nigeria. 2024;65(3):241-54.
Kearney, Patricia M. Global burden of hypertension: analysis of worldwide data. The Lancet. 2021;365(9455):217–23. DOI: https://doi.org/10.1016/S0140-6736(05)17741-1
Vaduganathan, M, Mensah, G, Turco, J. The Global Burden of Cardiovascular Diseases and Risk: A Compass for Future Health. JACC. 2022;80(25):2361–71. DOI: https://doi.org/10.1016/j.jacc.2022.11.005
Tajeu GS, Booth JN III, Colantonio LD. Incident cardiovascular disease among adults with blood pressure <140/90 mm Hg. Circulation 2017;136:798–812. DOI: https://doi.org/10.1161/CIRCULATIONAHA.117.027362
Mok D, Bednarz Jr J, Zieren J, Ferguson T, Glass J, Smith K, Yonish B. Double the prevalence of stage 2 hypertension readings in a small group of American pre-clinical medical students compared to young adults diagnosed with stage 2 hypertension in the United States. Cureus. 2020;12(3):7448. DOI: https://doi.org/10.7759/cureus.7448
AlWabel AH, Almufadhi MA, Alayed FM, Aloraini AY, Alobaysi HM, Alalwi RM. Assessment of hypertension and its associated risk factors among medical students in Qassim University. Saudi J of Kid Diseases and Transplantation. 2018;29(5):1100-8. DOI: https://doi.org/10.4103/1319-2442.243959
Nyombi KV, Kizito S, Mukunya D, Nabukalu A, Bukama M, Lunyera J, Asiimwe M, Kimuli I, Kalyesubula R. High prevalence of hypertension and cardiovascular disease risk factors among medical students at Makerere University College of Health Sciences, Kampala, Uganda. BMC Res Notes. 2016;9:1-6. DOI: https://doi.org/10.1186/s13104-016-1924-7
Siani A, Cappuccio FP, Barba G, Trevisan M, Farinaro E, Iacone R, et al. The relationship of waist circumference to blood pressure: the Olivetti Heart Study. American J of Hypert. 2002;15(9):780-6. DOI: https://doi.org/10.1016/S0895-7061(02)02976-X
Ghosh S, Kumar M. Prevalence and associated risk factors of hypertension among persons aged 15–49 in India: a cross-sectional study. BMJ open. 2019;9(12):29714. DOI: https://doi.org/10.1136/bmjopen-2019-029714