Pubertal hypertension is a strong predictor for the risk of adult hypertension

Objective: To assess and compare the predictive effects of hypertension before puberty and during puberty on adult hypertension.

Methods: A total of 412 adults from the "Beijing children and adolescents blood pressure (BP) study" cohort were followed up in a clinical examination in 2005. Systolic and diastolic BP, height, and weight in childhood were measured at a baseline survey in 1987. The participants were divided into pre-puberty and puberty sub-cohorts according to their pubertal development stage at baseline. Information on adult BP, anthropometric indices and life style were collected through questionnaire and physical examination. BP changes and the predictive effect on adult hypertension were compared between the two sub-cohorts. Correlation of BP levels between 1987 and 2005 was examined through linear regression models.

Results: From childhood to adulthood, the regression coefficients of systolic BP were similar in the two sub-cohorts (both β=0.34, P<0.001), while the coefficient of diastolic BP was larger in the pubertal cohort (β=0.31, P<0.001) compared with the pre-pubertal cohort (β=0.12, P=0.017). Fifty percent of children with pubertal hypertension became hypertensive adults, while pre-pubertal hypertension resulted in 34.3%. After adjustment for sex, age, family history of hypertension, obesity in childhood, and adulthood, pubertal hypertension predicted a higher risk of adult hypertension than pre-pubertal hypertension, with odds ratios (95% confidence intervals) of 10.00 (3.03-33.07) and 2.71 (0.83-8.85), respectively.

Conclusion: Our results suggest that hypertension during puberty is likely to result in adult hypertension.