Waist-to-Height Ratio as a Screening Marker of Elevated Blood Pressure in School-going Adolescents in North India
DOI:
https://doi.org/10.56450/JEFI.2026.v4i01.005Keywords:
Waist- height ratio, blood pressure, adolescents, school going, screeningAbstract
Introduction: The incidence of obesity and lifestyle changes have increased cardiovascular diseases (CVDs) prevalence, including diabetes and hypertension. Studies demonstrate that waist-height ratio (WHtR) correlates more strongly with cardiovascular risk variables than Body Mass Index and Waist Circumference. Objectives: To assess if waist to height (WHtR) ratio can be used as a future predictor of adult hypertension. Methods: This study assessed whether WHtR effectively screens for hypertension among school-going adolescents through a cross-sectional study examining 800 children aged 12-14 years in Aligarh Muslim University high schools using pre-tested questionnaires. Children present during examination and willing to participate were included, while those with preexisting comorbidities were excluded. Statistical analysis utilized IBM SPSS version 20.0. Results: The mean waist size measured 64.9±9.19 cm, with mean WHtR of 0.42±0.05 and mean systolic blood pressure of 110±12.7 mmHg. A statistically significant association (p=0.00) existed between systolic blood pressure and WHtR. Regression analysis revealed WHtR as a statistically significant systolic blood pressure predictor (R²=0.018, p=0.000). Conclusion: The waist-height ratio serves as a valid hypertension risk predictor in adulthood, emphasizing the necessity for early preventative efforts and lifestyle adjustments during adolescence to improve this ratio and reduce future cardiovascular disease risk.
Downloads
References
1. Nimkarn N, Sewarit A, Pirojsakul K, Paksi W, Chantarogh S, Saisawat P, et al. Waist-to-height-ratio is associated with sustained hypertension in children and adolescents with high office blood pressure. Front Cardiovasc Med. 2023 Jan 11;9:1026606.
2. Hardy ST, Urbina EM. Blood Pressure in Childhood and Adolescence. Am J Hypertens. 2021 Apr 2;34(3):242–9.
3. Bibiloni M del M, Gallardo-Alfaro L, Gómez SF, Wärnberg J, Osés-Recalde M, González-Gross M, et al. Combined Body Mass Index and Waist-to-Height Ratio and Its Association with Lifestyle and Health Factors among Spanish Children: The PASOS Study. Nutrients. 2022 Jan 6;14(2):234.
4. Ashwell M, Hsieh SD. Six reasons why the waist-to-height ratio is a rapid and effective global indicator for health risks of obesity and how its use could simplify the international public health message on obesity. Int J Food Sci Nutr. 2005 Jan 1;56(5):303–7.
5. Yoo EG. Waist-to-height ratio as a screening tool for obesity and cardiometabolic risk. Korean J Pediatr. 2016 Nov;59(11):425–31.
6. Nawab T, Khan Z, Khan IM, Ansari MA. Is small town India falling into the nutritional trap of metro cities? A study in school-going adolescents. J Fam Med Prim Care. 2016;5(3):581–6.
7. Choi JR, Koh SB, Choi E. Waist-to-height ratio index for predicting incidences of hypertension: the ARIRANG study. BMC Public Health. 2018 June 19;18(1):767.
8. National High Blood Pressure Education Program. The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. U.S. Department of Health and Human Services, National Heart, Lung, and Blood Institute; May 2005.
9. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004 Aug;114(2 Suppl 4th Report):555-76. Available from: https://www.nhlbi.nih.gov/files/docs/guidelines/child_tbl.
10. Aparicio-Cercós C, Alacreu M, Salar L, Moreno Royo L. Waist-to-height ratio and skipping breakfast are predictive factors for high blood pressure in adolescents. Sci Rep. 2020 Oct 7;10(1):16704.
11. Kuciene R, Dulskiene V. Associations between body mass index, waist circumference, waist-to-height ratio, and high blood pressure among adolescents: a cross-sectional study. Sci Rep. 2019 July 1;9(1):9493.
12. Powell-Wiley TM, Poirier P, Burke LE, Després JP, Gordon-Larsen P, Lavie CJ, et al. Obesity and Cardiovascular Disease: A Scientific Statement From the American Heart Association. Circulation. 2021 May 25;143(21):e984–1010.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Sameena Ahmad, M. Athar Ansari, Ali Jafar Abedi, Salman Khalil (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
