How common is hypertension in adolescents?

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In the past, hypertension in children and adolescents has been considered relatively uncommon, with about 1-2% of children having blood pressure persistently above the 95^th percentile for age, sex, and weight percentile. However, with the epidemic of childhood obesity and other recent environmental factors increasing, it is possible that the prevalence of hypertension is also increasing. In this issue of The Journal, McNiece et al evaluated this question by measuring blood pressure longitudinally in 6790 adolescents in Houston, Texas schools. After three consecutive screenings, they found that 15.7% of the population was persistently in the pre-hypertension range and 3.2% had hypertension. The likelihood of having pre-hypertension or hypertension increases with higher body mass index. These results mean that pediatricians should be identifying pre-hypertension and hypertension relatively frequently in the course of routine health care. Although the fate of adolescents with pre-hypertension is not completely known, adults with pre-hypertension are quite likely to become hypertensive over time. These results suggest that vigorous identification and treatment of both overweight and blood pressure elevation is needed in children and adolescents.

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