A Systematic Review of Risk Factors in Adolescents’ Predictors of High Blood Pressure in Adulthood

OBJECTIVES: To assess published evidence on adolescent risk factors for hypertension and their contribution to developing the disease in adulthood

METHODS: A systematic review was carried out. A search was performed in the Embase, Lilacs, Adolec, Medline, Cochrane Library databases, and manual search (cross-reference of included studies). Eligibility criteria: adolescents (12 to 17 years); cohort studies that measured adolescent risk factors and documented their long-term association with hypertension occurring in adulthood. Exclusion criteria: specific populations known to have a higher incidence of hypertension. The quality of studies was assessed by Newcastle-Ottawa Scale. (PROSPERO database ID: CRD42020172254)

RESULTS: All studies included (N = 37,901) were cohorts. The articles had a low risk of bias. Obese adolescents are more likely to report high blood pressure in young adulthood than normal-weight adolescents, N = 14,322, adjusted odds ratio (aOR) = 1.96; 95% confidence interval (CI) = 1.50-2.57. The increase in systolic and diastolic blood pressure results in adult hypertension (N= 1,082): systolic blood pressure OR= 1.45, 95% CI 1.09-1.91 for men and OR 1.32 (95% CI 1.02-1.71) for women, diastolic blood pressure OR=1.17, 95% CI 0.89-1.53 for men; and OR= 1.75 (95% CI 1.32-2.31) for women. In men, excessive alcohol consumption is a strong predictor of adult hypertension; adding it to models with childhood systolic and diastolic blood pressure and BMI increases the odds ratio for systolic blood pressure, OR= 2.46, 95% CI 1.18-5.77 and for diastolic blood pressure, OR= 2.41, 95% CI 1.17-1.97. For women, alcohol consumption: systolic blood pressure, OR= 0.70, 95% CI 1.17-2.99, and for diastolic blood pressure, OR= 1.04, 95% CI 0.22-4.97

CONCLUSIONS: Overweight and obesity doubled the chance of hypertension in adulthood; systolic and diastolic blood pressure increased the chance by 1.5 times. Salt intake and physical activity/sedentary lifestyle, independently, were not related to the development of hypertension.