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World J Hypertens. Nov 23, 2014; 4(4): 29-36
Published online Nov 23, 2014. doi: 10.5494/wjh.v4.i4.29
Epidemiology of elevated blood pressure in youth and its utility for predicting adulthood outcomes: A review
Rebecca K Kelly, Costan G Magnussen
Rebecca K Kelly, Costan G Magnussen, Menzies Research Institute Tasmania, University of Tasmania, Hobart 7000, Australia
Costan G Magnussen, Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, 20520 Turku, Finland
Author contributions: Kelly RK and Magnussen CG equally wrote and edited the manuscript.
Correspondence to: Costan G Magnussen, PhD, Menzies Research Institute Tasmania, University of Tasmania, Private Bag 23, Hobart 7000, Australia. cmagnuss@utas.edu.au
Telephone: +61-3- 62267762 Fax: +61-3-62267704
Received: July 24, 2014
Revised: August 29, 2014
Accepted: October 14, 2014
Published online: November 23, 2014
Processing time: 144 Days and 23.5 Hours
Abstract

Elevated blood pressure has been demonstrated to track from youth to adulthood and some have demonstrated an association between early-life blood pressure and subsequent atherosclerosis and cardiovascular disease. In addition, reports regarding the strength of tracking are inconsistent and the modifiable risk factors that affect the trajectory of blood pressure from youth to adulthood remain unclear. This paper comprehensively evaluated the existing classifications of youth hypertension and the current trends of youth hypertension. Further, evidence for the consequences of hypertension in youth has been comprehensively evaluated. Importantly, a review of the studies examining tracking from youth to adulthood has been performed and a number of studies investigating the factors affecting tracking has also been investigated. The overall consideration of this body of literature highlights the vital importance of identifying hypertension in youth to prevent complications in adulthood. Adiposity is regarded to be a factor affecting the progression of hypertension from youth to adulthood yet there is little evidence available for other modifiable factors. It is apparent that further research is necessary within this field in order to create effective preventative strategies to target youth hypertension.

Keywords: Pediatric; Children; Blood pressure; Hypertension; Epidemiology; Atherosclerosis

Core tip: Elevated blood pressure in youth predicts adult hypertension and end-stage organ damage but most youth with elevated blood pressure are left undiagnosed. In this review, we examine current classifications of youth blood pressure, recent trends in youth blood pressure, the adult consequences of elevated youth blood pressure, and lifestyle factors associated with improved blood pressure status from youth to adulthood. We show that identification of youth with elevated blood pressure may prove effective in preventing associated adult complications and that youth with elevated blood pressure may benefit most from interventions aimed at improvements to adiposity between youth and adulthood.