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Updated: Mar 31, 2026

Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Waist-to-Height Ratio as an Indicator of High Blood Pressure in Urban Indian School Children
P E Mishra1, L Shastri, T Thomas
1St. Johns Medical College, and; Divisions of #Epidemiology and Biostatistics, and Nutrition, St. Johns Research Institute; Bangalore, India; Division of Gastroenterology, Hepatology and Nutrition, and Boston Childrens Hospital, Boston, MA, USA; Department of Biostatistics, Harvard School of Public Health; Boston, MA, USA. Correspondence to: Dr Rebecca Kuriyan, Division of Nutrition, St. Johns Research Institute, Bangalore 560 034, India. rebecca@sjri.res.in.
Objective:
To examine the utility of waist-to-height ratio to identify risk of high blood pressure when compared to body mass index and waist circumference in South Indian urban school children.
Design:
Secondary data analysis from a cross-sectional study.
Setting:
Urban schools around Bangalore, India.
Participants:
1913 children (58.1% males) aged 6-16 years with no prior history of chronic illness (PEACH study).
Methods:
Height, weight, waist circumference and of blood pressure were measured. Children with blood pressure ?90th percentile of age-, sex-, and height-adjusted standards were labelled as having high blood pressure.
Results:
13.9% had a high waist-to-height ratio, 15.1% were overweight /obese and 21.7% had high waist circumference. High obesity indicators were associated with an increased risk of high blood pressure. The adjusted risk ratios (95% CI) of high systolic blood pressure with waist-to-height ratio, body mass index and waist circumference were 2.48 (1.76, 3.47), 2.59 (1.66, 4.04) and 2.38 (1.74, 3.26), respectively. Similar results were seen with high diastolic blood pressure.
Conclusion:
Obesity indicators, especially waist-to-height ratio due to its ease of measurement, can be useful initial screening tools for risk of high blood pressure in urban Indian school children.
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