title: Blood-pressure categories in adolescence predict development of hypertension in accordance with the European guidelines.
abstract: BACKGROUND
  It is estimated that by 2025, >1.5 billion adults worldwide will be hypertensive. Early identification of the population at risk would lead to improved utilization of preventive measures. We aimed to evaluate whether baseline body mass index (BMI) and blood-pressure (BP) values during adolescence (categorized according to the guidelines of the European Society of Hypertension-European Society of Cardiology) are of use in predicting the development of hypertension in young adulthood.
  
  
  METHODS
  The study population consisted of 18,513 male regular army personnel who were initially recruited at 16.5 and 19 years of age between 1976 and 1996. The main outcome was the percentage of subjects who developed hypertension (> or =140 systolic and > or =90 diastolic) at ages 26 to 45 years.
  
  
  RESULTS
  At baseline, BP categories were: optimal, 5961 (32.2%); normal, 7998 (43.2%); and high normal, 4554 (24.6%). Moreover, 1377 (7.4%) were overweight (BMI 25-30 kg/m(2)), and 199 (1.1%) were obese (BMI >30 kg/m(2)). At follow-up, 2277 (12.3%) subjects developed hypertension. The percentages progressing to hypertension were 9.46%, 11.99%, and 16.56% for optimal, normal, and high-normal categories, respectively (P < .01). Odds ratios (OR) for the development of hypertension in the normal and high-normal categories versus optimal were 1.30 (95% confidence interval [CI], 1.22-1.39) and 1.79 (95% CI, 1.67-1.93), respectively, adjusted for age and BMI. The ORs for hypertension in overweight and obese versus normal BMI were 1.75 (95% CI, 1.66-1.86) and 3.75 (95% CI, 3.45-4.07), adjusted for age and BP. Of 9762 remaining at ideal BMI at follow-up, the percentages progressing to hypertension were 5.3%, 6.4%, and 9.5% for optimal, normal, and high normal (at baseline) (P < .01).
  
  
  CONCLUSIONS
  The risk of developing hypertension in young adulthood may be predicted by BP categories and BMI at adolescence.
authors.affiliation: Institute of Gastroenterology, Division of Internal Medicine, Hebrew University-Hadassah Medical Center, Jerusalem, Israel.
authors.forename: Eran
authors.initials: E
authors.lastname: Israeli
authors.forename: Ze'ev
authors.initials: Z
authors.lastname: Korzets
authors.forename: Dorit
authors.initials: D
authors.lastname: Tekes-Manova
authors.forename: Amir
authors.initials: A
authors.lastname: Tirosh
authors.forename: Tzippy
authors.initials: T
authors.lastname: Schochat
authors.forename: Jacques
authors.initials: J
authors.lastname: Bernheim
authors.forename: Eliezer
authors.initials: E
authors.lastname: Golan
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001794:Blood Pressure / Q000502:physiology*; D015992:Body Mass Index; D018450:Disease Progression; D005060:Europe; D017408:Guidelines as Topic; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000503:physiopathology; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors