A study of body composition, muscle strength, and arterial stiffness in adolescents with primary and secondary hypertension.

BACKGROUND

Hypertension in adolescents is associated with early cardiovascular risk, yet functional and vascular differences between primary and secondary hypertension remain poorly characterized. This study aims to compare body composition, muscle strength, arterial stiffness, physical activity, and sedentary behavior among adolescents with primary and secondary hypertension compared with normotensive peers.

METHODS

Adolescents with primary hypertension (n = 35), secondary hypertension (n = 17), and normotensive controls (n = 21) were assessed for anthropometric characteristics, handgrip strength (HGS), hemodynamic and arterial stiffness parameters, physical activity levels, sedentary behavior, and perceived barriers to physical activity. Subgroup analyses were performed in adolescents with primary hypertension according to obesity status.

RESULTS

Adolescents with primary hypertension exhibited significantly higher body mass index and fat-free mass compared with other groups (p < 0.001). Pulse wave velocity was significantly higher in the primary hypertension group (p = 0.041), indicating increased arterial stiffness. Non-dominant HGS percentage was lowest in adolescents with secondary hypertension (p < 0.005). Physical activity levels were similarly low across groups, while weekend sedentary time was higher in the primary hypertension group (p = 0.021). Within the primary hypertension group, obesity status was not associated with differences in HGS, sedentary behavior, or arterial stiffness after adjustment for age, sex, height, and fat-free mass.

CONCLUSIONS

Adolescents with primary and secondary hypertension demonstrate distinct functional and vascular profiles early in the disease course. Arterial stiffness and reduced muscular strength highlight early cardiovascular risk, while low physical activity and high sedentary behavior are common across all groups. These findings support the need for early, individualized assessment and lifestyle-based interventions in adolescent hypertension.