Adolescent Hypertension

Blood pressure screening of 3537 high school students in the Harlem community was performed to determine the frequency distribution of blood pressures in this age group and to investigate the prevalence of hypertension in adolescence. The major inscription of the frequency distributions of both systolic and diastolic blood pressures was comparable among black, latin, and white students. However, female students of all races had lower systolic pressures than males. An over-all prevalence of 5.4% systolic and 7.8% diastolic hypertension was observed during the initial screening, and no significant difference in prevalence among the races was detected. With follow-up screening of those students with elevated blood pressures (BP ≧ 140/90 mm Hg) prevalence declined markedly to 1.2% systolic and 2.4% diastolic hypertension and showed that black males had a higher prevalence of persistent diastolic hypertension (3.7%) than all other groups. This difference did not achieve statistical significance; however, the racial comparison was not wholly satisfactory because of the limited sample of white students. Nevertheless, the observed prevalence in black males was more than twice that reported in the National Health Survey during a single screening. The data suggest two features of adolescent blood pressure which should be taken into account in hypertension detection programs for this age group: 1) the criteria selected to define blood pressure elevations in a maturing circulation would be more meaningful if related to the observed frequency distributions of blood pressure in an adolescent sample population. Values exceeding one standard deviation above the means reported herein are recommended (males: 132/85 mm Hg; females: 123/82 mm Hg); and 2) serial measurements of blood pressure appear to be required to detect the potentially hypertensive adolescent as well as to determine prevalence rates with accuracy. A finding which deserves further study is the striking increase in the percent of elevated blood pressures noted between the ages of 17 and 18 years, particularly in black males. Black males represent a vulnerable segment of the adult hypertensive population as well. The results indicate that over-all, contrary to traditional views, the development of hypertension may begin in adolescence and that methods of detection which appear satisfactory in adulthood are insufficient to uncover the true prevalence rates of hypertension in this age group.