Prehypertension in adolescents: risk and progression

Abstract

In 2004, the National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents recommended a new designation of prehypertension for children with mildly elevated blood pressure (BP). This description was intended to help identify children most at risk for the development of persistent hypertension for whom targeted prevention programs would be most beneficial and was based largely on expert opinions and epidemiologic normal values. This review summarizes the knowledge that has been gained regarding the epidemiology and risk associated with prehypertension in adolescents since its inception and highlights future challenges in understanding and preventing the development of hypertensive disease in this population.

Figure 1

Hypertensive classification of adolescents with elevated blood pressure (BP) based on mean BP per visit up to three total visits. High BP indicates blood pressure ≥90th percentile or 120/80 mm Hg; prehypertension (pre‐HTN), blood pressure ≥90th percentile or 120/80 mm Hg but <95th percentile; HTN, blood pressure ≥95th percentile ×3 visits. Adapted from Acosta and colleagues.³

Figure 2

Left ventricular mass in youth by blood pressure (BP) classification. *P<.05 normotensive vs prehypertensive patients; P<.01 normotensive vs hypertensive patients. ^† P<.05 for normotensive patients <prehypertensive patients <hypertensive patients.