title: Prevalence of hypertension and pre-hypertension among adolescents.
abstract: OBJECTIVE
  To determine the prevalence of hypertension and pre-hypertension on the basis of the 2004 National High Blood Pressure Education Program Working Group guidelines in an adolescent school-screening population.
  
  
  METHODS
  Cross-sectional assessment of blood pressure (BP) in 6790 adolescents (11-17 years) in Houston schools was conducted from 2003 to 2005. Initial measurements included height, weight, and 4 oscillometric BP readings. Repeat measurements were obtained on 2 subsequent occasions in students with persistently elevated BP. Final prevalence was adjusted for loss to follow-up and logistic regression used to assess risk factors.
  
  
  RESULTS
  BP distribution at initial screen was 81.1% normal, 9.5% pre-hypertension, and 9.4% hypertension (8.4% Stage 1; 1% Stage 2). Prevalence after 3 screenings was 81.1% normal, 15.7% pre-hypertension, and 3.2% hypertension (2.6% Stage 1; 0.6% Stage 2). Hypertension and pre-hypertension increased with increasing body mass index. Sex, race, and classification as either at-risk for overweight or overweight were independently associated with pre-hypertension. Only classification as overweight was associated with hypertension.
  
  
  CONCLUSIONS
  Application of new classification guidelines for adolescents with elevated BP reveals approximately 20% are at risk for hypertension. Further research determining the significance of each BP category and refining definitions to account for BP variability is warranted.
authors.affiliation: Department of Pediatrics, Division of Pediatric Nephrology and Hypertension, University of Texas-Houston, School of Medicine, Houston, Texas 77057, USA. karen.l.mcniece@uth.tmc.edu
authors.forename: Karen L
authors.initials: KL
authors.lastname: McNiece
authors.forename: Timothy S
authors.initials: TS
authors.lastname: Poffenbarger
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Turner
authors.forename: Kathy D
authors.initials: KD
authors.lastname: Franco
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Sorof
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Portman
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000208:ethnology; D008297:Male; D013781:Texas / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data