Blood pressure variability and classification of prehypertension and hypertension in adolescence.
OBJECTIVE
There is little information in pediatrics on the persistence of the prehypertension and hypertension classifications or on the progression of prehypertension to hypertension. This study aimed to examine those issues.


METHODS
An analysis of data from the National Childhood Blood Pressure database was conducted to examine the longitudinal blood pressure outcomes for adolescents classified after a single measurement of blood pressure. Adolescent subjects (N = 8535) for whom serial single blood pressure measurements were obtained at intervals of 2 years were identified. Subjects were stratified according to blood pressure status at the initial measurement, as having normotension, prehypertension, or hypertension.


RESULTS
Among subjects designated as having prehypertension (n = 1470), 14% of boys and 12% of girls had hypertension 2 years later. Among subjects designated as having hypertension, 31% of boys and 26% of girls continued to exhibit hypertension, and 47% of boys and 26% of girls had blood pressure values in the prehypertensive range. Regression models showed no significant effect of race on blood pressure changes but significant effects of initial BMI and changes in BMI.


CONCLUSIONS
These data indicated that the rate of progression of prehypertension to hypertension was approximately 7% per year. Prehypertension can be predictive of future hypertension and may benefit from preventive interventions, especially lifestyle changes.
Falkner
Bonita
B
Department of Medicine, Thomas Jefferson University, 833 Chestnut St, Suite 700, Philadelphia, PA 19107, USA. bonita.falkner@jefferson.edu
Gidding
Samuel S
SS
Portman
Ronald
R
Rosner
Bernard
B
D000293:Adolescent; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination / Q000145:classification*; D015992:Body Mass Index; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000145:classification* / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D015999:Multivariate Analysis; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D011336:Probability; D012042:Registries; D012044:Regression Analysis; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution