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Adolescent BP Predicts Hypertension in Young Adulthood

Risk more than doubles if systolic BP is 130 to 139 mm Hg at age 17; BMI also a predictor

MONDAY, June 14 (HealthDay News) -- Blood pressure (BP) at age 17 rises over time in a linear fashion, and both male and female adolescents with BPs in the upper range of normal face more than double the risk of hypertension in young adulthood, according to research published online June 14 in Hypertension.

Amir Tirosh, M.D., of the Brigham and Women's Hospital in Boston, and colleagues conducted a prospective study of 23,191 male and 3,789 female adolescents with a mean age of 17.4 years, following them with repeated BP measurements from age 25 to 42, as well as retrospective follow-up for incident hypertension between ages 17 and 25. The researchers aimed to better understand how BP in adolescence predicts BP in young adulthood. An additional measured outcome was the effect of body mass index (BMI) in adolescence on the risk of future hypertension.

The investigators discovered that the risk of hypertension gradually increased over time in both genders across BP groups in the normotensive range at age 17; there was no lower threshold level of BP for this finding. Having a BP of 130 to 139/85 to 89 mm Hg at age 17 translated to a hazard ratio for hypertension by age 42 of 2.50 in males and 2.31 in females. The cumulative risk of hypertension between ages 25 and 42 was three to four times higher in males. BMI at age 17 was also strongly associated with the risk of later hypertension, particularly for boys, while BMI at age 30 had an attenuating effect on hypertension risk, particularly for females.

"The study demonstrates the potential predictive value of even a single BP measurement. Thus, along with existing guidelines, these findings call for high awareness for pediatricians in using an integrated individualized assessment that incorporates sex and late adolescence BP and BMI in predicting the risk of hypertension in young adulthood, an age group that frequently escapes continuous medical attention," the authors write.

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