title: Development of hypertension in adolescents with pre-hypertension.
abstract: OBJECTIVE
  To evaluate the risk for developing incident hypertension (HTN) in adolescents with pre-hypertension.
  
  
  METHODS
  A secondary analysis of students participating in multiple school-based blood pressure (BP) screens from 2000 to 2007 was completed. At each screen, height, weight, and 2 to 4 BPs were measured on as many as 3 occasions when BP remained ≥ 95th percentile. Students with confirmed HTN at their initial screen were excluded, and incident HTN was defined as having a BP ≥ 95th percentile at all 3 visits of a later screen. Incidence rates (IR) and hazard ratios (HR) were calculated by using Cox Proportional models.
  
  
  RESULTS
  Of 1006 students, HTN developed in 11 (IR 0.5%/year) in a mean of 2.1 years of observation. IRs were higher in "at-risk" students (pre-hypertensive or hypertensive with follow-up BP <95th percentile), 1.4%/year (HR, 4.89; 1.48-16.19) and students with a BP ≥ 90th percentile at 3 baseline visits, 6.6%/year HR 24.33 (5.68-104.29)]. Although not significant, students with pre-hypertension by the 2004 Task Force definition also had an increased IR of 1.1%/year (HR, 2.98; 0.77-11.56)].
  
  
  CONCLUSIONS
  Elevated BP increases the risk for the development of HTN during adolescence. Effective strategies for preventing HTN in at-risk adolescents are needed.
authors.affiliation: Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA. redwinekarenm@uams.edu
authors.forename: Karen M
authors.initials: KM
authors.lastname: Redwine
authors.forename: Alisa A
authors.initials: AA
authors.lastname: Acosta
authors.forename: Timothy
authors.initials: T
authors.lastname: Poffenbarger
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Portman
authors.forename: Joshua
authors.initials: J
authors.lastname: Samuels
mesh_terms: D000293:Adolescent; D002648:Child; D018450:Disease Progression; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D058246:Prehypertension / Q000150:complications*; D018570:Risk Assessment; D055815:Young Adult