Current Hypertension Reports

, Volume 14, Issue 6, pp 619–625

Progression of Prehypertension to Hypertension in Adolescents

Pediatric Hypertension (JT Flynn, Section Editor)

Abstract

In the 2004 report from the National High Blood Pressure (BP) Education Program Working Group on BP in Children and Adolescents, the term “high normal BP” was replaced with the designation “prehypertension”. It was proposed that BP levels that were higher than normal but did not reach the level of hypertension posed an increased risk for progression to hypertension. The overall intent of this description was to help identify children who were at the greatest risk for the development of hypertension. These are children and adolescents for whom targeted prevention programs are expected to be most beneficial. Following the 2004 report, the prehypertension condition has been examined and described in adolescents as well as adults. This review summarizes the knowledge that has been gained on prehypertension including clinical characteristics, rates of progression to hypertension, and evidence of cardiovascular pathology.

Keywords

Prehypertension Hypertension Blood pressure BP Pediatrics Adolescents Cardiovascular disease Risk Prevention Lifestyle changes 

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    National Heart L, Blood Institute. Report of the task force on blood pressure control in children. Pediatrics. 1977;59:797–820.Google Scholar
  2. 2.
    Falkner B. Recent advances in pediatric hypertension. Journal of clinical hypertension (Greenwich, Conn;14(6):345.Google Scholar
  3. 3.
    Chen X, Wang Y. Tracking of blood pressure from childhood to adulthood: a systematic review and meta-regression analysis. Circulation. 2008;117(25):3171–80.CrossRefPubMedGoogle Scholar
  4. 4.
    Falkner B, Development of Blood Pressure Norms in Children. In Pediatric Hypertension, Second edition. Editors Flynn JT, Ingelfinger JR, and Portman RJ. New York: Humana Press; 201, pp 135-146.Google Scholar
  5. 5.
    The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 2004;114(2 Suppl 4th Report):555-76.Google Scholar
  6. 6.
    Chobanian AV, Bakris GL, Black HR, et al. Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension. 2003;42(6):1206–52.CrossRefPubMedGoogle Scholar
  7. 7.
    Urbina E, Alpert B, Flynn J, et al. Ambulatory blood pressure monitoring in children and adolescents: recommendations for standard assessment: a scientific statement from the American Heart Association Atherosclerosis, Hypertension, and Obesity in Youth Committee of the council on cardiovascular disease in the young and the council for high blood pressure research. Hypertension. 2008;52(3):433–51.CrossRefPubMedGoogle Scholar
  8. 8.
    White WB. Importance of aggressive blood pressure lowering when it may matter most. Am J Cardiol. 2007;100(3A):10J–6J.CrossRefPubMedGoogle Scholar
  9. 9.
    Sorof JM, Cardwell G, Franco K, Portman RJ. Ambulatory blood pressure and left ventricular mass index in hypertensive children. Hypertension. 2002;39(4):903–8.CrossRefPubMedGoogle Scholar
  10. 10.
    Chamontin B, Amar J, Barthe P, Salvador M. Blood pressure measurements and left ventricular mass in young adults with arterial hypertension screened at high school check-up. J Hum Hypertens. 1994;8(5):357–61.PubMedGoogle Scholar
  11. 11.
    Lurbe E, Torro I, Alvarez V, et al. Prevalence, persistence, and clinical significance of masked hypertension in youth. Hypertension. 2005;45(4):493–8.CrossRefPubMedGoogle Scholar
  12. 12.
    McNiece KL, Gupta-Malhotra M, Samuels J, et al. Left ventricular hypertrophy in hypertensive adolescents: analysis of risk by 2004 National High Blood Pressure Education Program Working Group staging criteria. Hypertension. 2007;50(2):392–5.CrossRefPubMedGoogle Scholar
  13. 13.
    Stabouli S, Kotsis V, Toumanidis S, Papamichael C, Constantopoulos A, Zakopoulos N. White-coat and masked hypertension in children: association with target-organ damage. Pediatr Nephrol. 2005;20(8):1151–5.CrossRefPubMedGoogle Scholar
  14. 14.
    Lande MB, Carson NL, Roy J, Meagher CC. Effects of childhood primary hypertension on carotid intima media thickness: a matched controlled study. Hypertension. 2006;48(1):40–4.CrossRefPubMedGoogle Scholar
  15. 15.
    Munter PHJ, Cutler JA, Wildman RP, Welton PK. Trends in blood pressure among children and adolescents. JAMA. 2004;291:2107–13.CrossRefGoogle Scholar
  16. 16.
    Din-Dzietham R, Liu Y, Bielo MV, Shamsa F. High blood pressure trends in children and adolescents in national surveys, 1963 to 2002. Circulation. 2007;116(13):1488–96.CrossRefPubMedGoogle Scholar
  17. 17.
    Sorof JM, Lai D, Turner J, Poffenbarger T, Portman RJ. Overweight, ethnicity, and the prevalence of hypertension in school-aged children. Pediatrics. 2004;113(3 Pt 1):475–82.CrossRefPubMedGoogle Scholar
  18. 18.
    • McNiece KL, Poffenbarger TS, Turner JL, Franco KD, Sorof JM, Portman RJ. Prevalence of hypertension and pre-hypertension among adolescents. J Pediatr. 2007;150(6):640–4. 4 e1. The authors provide data, based on school BP screening, to demonstrate the prevalence of prehypertension among healthy adolescents.CrossRefPubMedGoogle Scholar
  19. 19.
    • Acosta AA, Samuels JA, Portman RJ, Redwine KM. Prevalence of persistent prehypertension in adolescents. J Pediatr. 2011. The authors provide data on the prevalence of prehypertension verified on more than one BP measurement.Google Scholar
  20. 20.
    Genovesi S, Giussani M, Pieruzzi F, et al. Results of blood pressure screening in a population of school-aged children in the province of Milan: role of overweight. J Hypertens. 2005;23(3):493–7.CrossRefPubMedGoogle Scholar
  21. 21.
    Antal M, Regoly-Merei A, Nagy K, et al. Representative study for the evaluation of age- and gender-specific anthropometric parameters and blood pressure in an adolescent Hungarian population. Ann Nutr Metab. 2004;48(5):307–13.CrossRefPubMedGoogle Scholar
  22. 22.
    Kardas P, Kufelnicka M, Herczynski D. Prevalence of arterial hypertension in children aged 9-14 years, residents of the city of Lodz. Kardiol Pol. 2005;62(3):211–6. discussion 6-7.PubMedGoogle Scholar
  23. 23.
    Saleh EA, Mahfouz AA, Tayel KY, Naguib MK, Bin-al-Shaikh NM. Hypertension and its determinants among primary-school children in Kuwait: an epidemiological study. East Mediterr Health J. 2000;6(2–3):333–7.PubMedGoogle Scholar
  24. 24.
    • Hansen ML, Gunn PW, Kaelber DC. Underdiagnosis of hypertension in children and adolescents. JAMA. 2007;298(8):874–9. The prevalence of prehypertension based on at least three separate measurements in children from 3 to 18 years in pediatric primary care clinics is reported. Data were derived from electronic medical records. The focus of this report was to verify that high BP, both hypertension and prehypertension, is not recognized by clinicians.CrossRefPubMedGoogle Scholar
  25. 25.
    Chiolero A, Paccaud F, Bovet P. Pre-hypertension and hypertension among adolescents of Switzerland. J Pediatr. 2007;151(6):e24–5.CrossRefPubMedGoogle Scholar
  26. 26.
    Falkner B, Gidding SS, Portman R, Rosner B. Blood pressure variability and classification of prehypertension and hypertension in adolescence. Pediatrics. 2008;122(2):238–42.CrossRefPubMedGoogle Scholar
  27. 27.
    Jago R, Harrell JS, McMurray RG, Edelstein S, El Ghormli L, Bassin S. Prevalence of abnormal lipid and blood pressure values among an ethnically diverse population of eighth-grade adolescents and screening implications. Pediatrics. 2006;117(6):2065–73.CrossRefPubMedGoogle Scholar
  28. 28.
    Zhu H, Yan W, Ge D, et al. Cardiovascular characteristics in American youth with prehypertension. Am J Hypertens. 2007;20(10):1051–7.CrossRefPubMedGoogle Scholar
  29. 29.
    Bao W, Threefoot SA, Srinivasan SR, Berenson GS. Essential hypertension predicted by tracking of elevated blood pressure from childhood to adulthood: the Bogalusa Heart Study. Am J Hypertens. 1995;8(7):657–65.CrossRefPubMedGoogle Scholar
  30. 30.
    •• Redwine KM, Acosta AA, Poffenbarger T, Portman RJ, Samuels J. Development of hypertension in adolescents with pre-hypertension. J Pediatr. 2012;160(1):98–103. The authors provide the first report on progression from prehypertension to hypertension in adolescents that is based on prospective data.CrossRefPubMedGoogle Scholar
  31. 31.
    Falkner B. Prehypertension in adolescents: how high is the risk for hypertension? J Pediatr. 2012;160(1):7–9.CrossRefPubMedGoogle Scholar
  32. 32.
    Vasan RS, Larson MG, Leip EP, Kannel WB, Levy D. Assessment of frequency of progression to hypertension in non-hypertensive participants in the Framingham Heart Study: a cohort study. Lancet. 2001;358(9294):1682–6.CrossRefPubMedGoogle Scholar
  33. 33.
    Richey PA, Disessa TG, Hastings MC, Somes GW, Alpert BS, Jones DP. Ambulatory blood pressure and increased left ventricular mass in children at risk for hypertension. J Pediatr. 2008;152(3):343–8.CrossRefPubMedGoogle Scholar
  34. 34.
    Stabouli S, Kotsis V, Rizos Z, et al. Left ventricular mass in normotensive, prehypertensive and hypertensive children and adolescents. Pediatr Nephrol. 2009;24(8):1545–51.CrossRefPubMedGoogle Scholar
  35. 35.
    Drukteinis JS, Roman MJ, Fabsitz RR, et al. Cardiac and systemic hemodynamic characteristics of hypertension and prehypertension in adolescents and young adults: the Strong Heart Study. Circulation. 2007;115(2):221–7.CrossRefPubMedGoogle Scholar
  36. 36.
    Tu W, Eckert GJ, DiMeglio LA, Yu Z, Jung J, Pratt JH. Intensified effect of adiposity on blood pressure in overweight and obese children. Hypertension. 2011;58(5):818–24.CrossRefPubMedGoogle Scholar
  37. 37.
    Falkner B DS, Keith SW, Gidding SS Both high risk blood pressure and obesity increase the risk for left ventricular hypertrophy in African American adolescents. The Journal of pediatrics 2012(in press).Google Scholar
  38. 38.
    Urbina EM, Khoury PR, McCoy C, Daniels SR, Kimball TR, Dolan LM. Cardiac and vascular consequences of pre-hypertension in youth. J Clin Hypertens (Greenwich). 2011;13(5):332–42.CrossRefGoogle Scholar
  39. 39.
    Daniels SR, Pratt CA, Hayman LL. Reduction of risk for cardiovascular disease in children and adolescents. Circulation. 2011;124(15):1673–86.CrossRefPubMedGoogle Scholar
  40. 40.
    Julius S, Nesbitt SD, Egan BM, et al. Feasibility of treating prehypertension with an angiotensin-receptor blocker. N Engl J Med. 2006;354(16):1685–97.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of Pediatrics, Division of Pediatric NephrologyUniversity of Arkansas for Medical Sciences & Arkansas Children’s HospitalLittle RockUSA
  2. 2.Department of Medicine, Jefferson School of MedicineThomas Jefferson UniversityPhiladelphiaUSA
  3. 3.Department of Pediatrics, Jefferson School of MedicineThomas Jefferson UniversityPhiladelphiaUSA
  4. 4.Division of Nephrology – MedicinePhiladelphiaUSA

Personalised recommendations