Digital media use and blood pressure in adolescents

Hypertension is an increasingly important health concern among children and adolescents. Beyond traditional risk factors such as obesity, sedentary behaviors, including prolonged internet use and video gaming, may contribute to elevated blood pressure. This study aimed to investigate the association between problematic internet use, video gaming, and ambulatory blood pressure parameters in adolescents.

This cross-sectional study included adolescents aged 12-18 years who were referred to a pediatric nephrology outpatient clinic for evaluation of hypertension. Demographic, clinical, and laboratory data were obtained from medical records. Ambulatory blood pressure monitoring (ABPM) was performed to classify ambulatory hypertension and white coat hypertension. Internet use and gaming behaviors were assessed using the Young Internet Addiction Scale (YIA-SF) and the Internet Gaming Disorder Scale (IGDS9-SF). Scale scores were compared with ABPM parameters.

A total of 107 adolescents (40 girls, 67 boys) with a mean age of 14.9 ± 1.8 years were included. Based on ABPM findings, 55 participants (51.4%) had ambulatory hypertension, while 52 (48.6%) had white coat hypertension. Higher YIA-SF scores were weakly but significantly associated with higher mean daytime systolic blood pressure. IGDS9-SF scores were not significantly associated with ambulatory blood pressure parameters.

Problematic internet use may be associated with higher mean daytime systolic blood pressure in adolescents, including among non-obese individuals. Although these behaviors were not independent predictors of ambulatory hypertension after adjustment for demographic and anthropometric factors, awareness of screen-based behaviors may complement lifestyle counseling in adolescents evaluated for elevated blood pressure.

• The majority of pediatric studies examining the relationship between screen-based behaviors and blood pressure have been based on office blood pressure measurements, which may not fully capture circadian blood pressure patterns compared with ambulatory blood pressure monitoring.

• This study contributes to the limited literature examining the association between problematic internet use, video gaming, and ambulatory blood pressure parameters in adolescents. • Higher internet addiction scores were associated with higher mean daytime blood pressure, including among non-obese adolescents.