Objective  To investigate the prevalence of hypertension among children and adolescents aged 6 to 17 years old in Henan Province, and analyze the related influencing factors.

Methods  From February to November 2023, a multi-stage stratified random cluster sampling method was employed to select 18 monitoring sites across the province. In each monitoring site, 2 primary schools, 2 middle schools, and 2 high schools were randomly selected. Sampling was then stratified by grade level, with classes serving as the unit for random cluster sampling. A total of 29 109 respondents were included in the survey. Data on students' basic information, lifestyle, and blood pressure levels were collected through questionnaires and physical examinations. Chi-square tests and multivariate logistic regression models were used to explore the influencing factors of hypertension among children and adolescents.

Results  The detection rate of hypertension among children and adolescents aged 6 to 17 was 7.0% (95%CI: 6.7% to 7.3%), and the national standard rate was 6.9%. Which was higher in boys than that in girls (8.1% 1108/13679 vs 5.9% 754/12860, χ² = 50.838, P＜0.001), and was higher in urban areas than in rural areas (7.6% 876/11535 vs 6.6% 986/15 004, χ² = 10.455, P = 0.001). Multivariate logistic regression analysis revealed that the following factors were significantly associated with hypertension: gender (boys, OR = 1.180, 95%CI: 1.066 to 1.307), age (12 to < 18 years old, OR = 1.402, 95%CI: 1.216 to 1.616), BMI (overweight, OR = 1.834, 95%CI: 1.579 to 2.131; obesity, OR = 3.775, 95%CI: 3.103 to 4.592), waist circumference (high waist circumference, OR = 1.380, 95%CI: 1.158 to 1.644), dyslipidemia (hypercholesterolemia, OR = 1.513, 95%CI: 1.152 to 1.987; low high-density lipoprotein cholesterol, OR = 1.420, 95%CI: 1.164 to 1.731; hypertriglyceridemia, OR = 1.345, 95%CI: 1.141 to 1.585), sleep duration (insufficient sleep, OR = 1.138, 95%CI: 1.010 to 1.282), daily sedentary time (third tertile, OR = 1.151, 95%CI: 1.002 to 1.323) and education level of the primary caregiver (high school, technical secondary school and junior college, OR = 0.882, 95%CI: 0.789 to 0.985; bachelor's degree or above, OR = 0.675, 95%CI: 0.539 to 0.845).

Conclusions  The epidemiological characteristics of hypertension among children and adolescents in Henan Province indicate higher prevalence rates among urban students, males, and those aged 12 and above. Major influencing factors include overweight, obesity, dyslipidemia, prolonged sedentary time, and insufficient sleep. It is recommended to enhance early screening efforts, promote the forward shift of prevention and control measures, and implement lifestyle interventions targeting these key factors.