Prevalence and Risk Factors for Hypertension in Adolescents Aged 12 to 17 Years: A School-Based Study in China

Hypertension in adolescents has attracted increasing attention. However, large, well-designed studies accurately demonstrating epidemiological characteristics of adolescent hypertension remain insufficient. We, therefore, conducted a population-based multicenter study with repeated blood pressure visits to offer precise prevalence of it. We randomly recruited 42 025 adolescents aged 12 to 17 years in 6 centers throughout China from 2018 to 2019. The initial hypertension was estimated in all centers through one blood pressure measurement visit. Confirmed hypertension was evaluated in 3 blood pressure visits in 2 of 6 centers including 16 220 subjects. Hypertension was defined using American and Chinese guidelines and standardized by sex and age using 2010 China population census data. Standardized prevalence of initial and confirmed hypertension were 18.6% (95% CI, 17.3%–20.0%) and 5.9% (95% CI, 4.7%–7.2%) using 2017 American Association Pediatrics hypertension guidelines, respectively and which were 24.5% (95% CI, 23.0%–25.9%) and 8.8% (95% CI, 7.3%–10.3%) using 2018 Chinese hypertension guidelines. Male (odds ratio [OR], 1.275 [95% CI, 1.070–1.520]), parental hypertension history (OR, 1.387 [95% CI, 1.159–1.660]), higher heart rate (OR, 1.043 [95% CI, 1.037–1.049]), higher waist circumference (OR, 1.036 [95% CI, 1.027–1.046]), and adiposity indexes including overweight (OR, 2.211 [95% CI, 1.781–2.745]), and obesity (OR, 3.085 [95% CI, 2.330–4.084]) were identified as risk factors. In conclusion, the prevalence of hypertension was quite high evaluated by both guidelines with several risk factors, and a single blood pressure measurement visit leads to an overestimation of hypertension prevalence among adolescents.