Correlates of Hypertensive-Level BP in African American Adolescents

Adult cardiovascular disease has its roots in childhood and adolescence. Risks for pediatric hypertension include obesity, male sex, and minority race. We identified risk factors associated with hypertension specifically among African American adolescents ages 13-18.

We analyzed data from the US National Health and Nutrition Examination Surveys from 2011 to 2018, defining BP consistent with hypertension as average systolic or diastolic BP ≥ 130/80 mmHg or taking medication for a clinical diagnosis of hypertension. Univariate analyses compared characteristics of adolescents with and without hypertensive-level BP. Logistic regression was completed to more precisely identify risk factors.

Among 838 African American adolescents, 48 met criteria for hypertensive-level BP, for a population prevalence of 5.8%. Due to low rates of hypertensive-level BP in girls (2.7%), our analysis focused on the subset of boys, who had an 8.9% prevalence rate, increasing to 26.1% for boys with obesity and 35.3% for boys with severe obesity. Boys with hypertensive-level BP had significantly lower family incomes, higher rates of being in single-parent families, more frequent consumption of fast food, were more likely to be taking prescription medications for psychiatric diagnoses, and had higher A1c and cholesterol values.

Our study confirms the much higher risk for hypertensive-level BP in African American boys and emphasizes the important role of social determinants of health in this common illness.