Hypertension in Low-Income Adolescents

What is it about?

This study assessed the prevalence of obesity and hypertension in 573 patients aged 13.0-17.9 years from a clinic serving low income, ethnically diverse pediatric patients in central North Carolina, and evaluated certain activity/lifestyle behaviors reported by the patients. The total combined prevalence of abnormal blood pressure in this cohort was 43.1% (n=247). These results are significantly higher than the highest estimated U.S. rates for prehypertension (15%) and hypertension (5%), which would give a combined rate of 20%. In addition to elevated blood pressure, the prevalence of overweight and obesity were very high in this adolescent population, especially among the boys, and were not mitigated by relatively limited fast food intake and relatively high rates of participation in regular exercise. In this cohort, a large number of “normal” weight adolescents had elevated blood pressure. Furthermore, weight had a greater correlation with blood pressure in boys (fewer overweight and obese boys than girls were normotensive) and elevated blood pressure in boys occurred at a lesser degree of adiposity than in girls (more boys than girls had abnormal blood pressure). While this study did not screen for diabetes or metabolic syndrome, immigrants and minorities have increased risks associated with their specific racial and ethnic heritage, and these patients were at much higher risk for these conditions because of their weight and BP status.

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Why is it important?

Adolescent hypertension and obesity have life-long consequences that become more inevitable with delayed diagnosis and treatment. Disadvantaged youth are at higher risk for undiagnosed and untreated obesity and hypertension. Not only are obesity rates higher in this population, but they typically have limited financial resources, less access to preventive health care, fewer sources for healthy food choices, and are less likely to participate in weight management programs or have access to safe play areas or exercise facilities. They also have more psychosocial stressors, higher rates of undiagnosed or untreated hypertension and mental health issues, and a higher risk of becoming obese.

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