Development of hypertension in a cohort of Cuban adolescents.

INTRODUCTION

Primary hypertension has its origins in childhood and is a risk factor for atherosclerosis; it is considered an important health problem because of its high prevalence worldwide.

OBJECTIVE

Describe the development of hypertension during adolescence, including some factors that influence its persistence and progression in Cuban adolescents.

METHODS

A cohort study was conducted in an intentional sample of 252 apparently healthy adolescents from the catchment area of the Héroes del Moncada Polyclinic in Plaza de la Revolución Municipality, Havana. They were assessed in two cross-sectional studies in 2004 and 2008. Mean age at first assessment was 13.2 years, 17.1 years at the second. Variables were weight, height, body mass index, waist circumference, blood pressure, smoking, family history of hypertension and birth weight. Correlation coefficients and growth curve analyses were applied to assess blood pressure persistence. Risk of developing prehypertension and hypertension was estimated in the second assessment, based on predictors identified in the 2004 cut. Forecasting models with these factors were developed using classification trees as analytical tools.

RESULTS

Of the six adolescents categorized as hypertensive in the first assessment, five still showed blood pressure alterations after four years. The main factors related to hypertension in those aged 16-19 were blood pressure itself and a body mass index >90th percentile, followed by low birth weight and abdominal obesity. Prognostic models for predicting this condition at the end of adolescence demonstrated the importance of blood pressure alterations at age 12-15 years.

CONCLUSIONS

High rates of persistence and progression of hypertension during adolescence highlights the need for systematic blood pressure screening at the primary health care level and adoption of primary prevention strategies beginning in childhood.