Higher BP in adolescence predicts increased risk of BP in adulthood, even among adolescents with BP in normal range, data show

Higher blood pressure (BP) values during adolescence predict an increased risk of hypertension in adulthood, even in the range of normal BP, according to findings from a study conducted at the Israel Defense Forces Staff Periodic Examination Center. Researchers evaluated the association between BP at age 17 years and the subsequent risk of hypertension in 23,191 males and 3,789 females who were members of the Metabolic Lifestyle and Nutrition Assessment in Young Adults cohort. All...

Higher blood pressure (BP) values during adolescence predict an increased risk of hypertension in adulthood, even in the range of normal BP, according to findings from a study conducted at the Israel Defense Forces Staff Periodic Examination Center.

Researchers evaluated the association between BP at age 17 years and the subsequent risk of hypertension in 23,191 males and 3,789 females who were members of the Metabolic Lifestyle and Nutrition Assessment in Young Adults cohort. All participants underwent a baseline examination at age 17 or 18 years (mean age, 17.4 years) before recruitment for compulsory military service. Subsequently, the participants underwent follow-up examinations every 3 to 5 years beginning at age 25 years (median time from enrollment to end of follow-up, 14 years); none of the participants included in the current analysis had hypertension at baseline.

During follow-up, there were 3,810 new cases of hypertension. The results showed that the cumulative risk of hypertension between ages 17 and 42 years was 3 to 4 times greater in men than in women.

To evaluate the risk of hypertension in adulthood as a function of adolescent BP, the participants were stratified by BP at age 17 years (<100/70 mm Hg, 100-109/70-74 mm Hg, 110-119/75-79 mm Hg, 120-129/80-84 mm Hg, and 130-139/85-89 mm Hg), with BP group classification according to the highest of either systolic or diastolic BP.

The risk of hypertension during adulthood increased with increasing BP category among both men and women (P<.001 for both trends). These trends remained significant after adjustment for age and body mass index (BMI) at age 17 years (P<.001 for men and P=.03 for women).

The adjusted hazard ratio for hypertension during follow-up was 2.5 (95% CI, 1.75-3.57) for men in the highest BP quintile (as compared with the lowest BP quintile) and 2.31 (95% CI, 0.71-7.60) for women in the highest BP quintile.

The study authors noted that BMI at age 17 years was strongly associated with future risk of hypertension, even after adjustment for BP at age 17 years, particularly among the men. At the same time, BMI at age 30 years attenuated this association, particularly among the women.

Based on these results, the study authors concluded that "BP at adolescence, even in the low-normotensive range, linearly predicts progression to hypertension in young adulthood."

They added, "This progression and the apparent interaction between BP at age 17 years and BMI at adolescence and at adulthood are sex-dependent." (Tirosh A, et al. Hypertension 2010;56:203-209.)