Now is the Time to Treat Hypertension in Adolescents

• Prevalence of hypertension was found to be 8.0% among males and 6.5% among females.
• Clinicians should immediately start to screen adolescents for hypertension and to treat it when it is found.
• Analysis reviewed 22 trials.
• More than 14,000 adolescents were included in the examination.

Hypertension was found to be highly prevalent among high blood students according to a recent systematic review. Hypertension is associated with a number of co-morbidities if it is not controlled (Figure 1). However, treatment of high blood pressure, even in adolescents, is easily implemented. It can reduce associated morbidity and mortality. The results were published in Revista de Saúde Pública.

The Analysis

The primary outcome in this review was the prevalence of arterial hypertension—with a 95% confidence interval (95%CI). Summary measures were estimated for the total population and subgroups according to sex, study quality, method and number of measurements, sample estimation, and region, the authors explained. The meta-analysis was estimated using a random effects model and was weighted by the inverse of the variance. Heterogeneity was evaluated by the chi-squared test with a significance of P<0.10. The magnitude of heterogeneity was measured using I-squared (I²).

The reviewers examined 22 trials that included 14,115 adolescents in Brazil, 51.2% of whom were female. “The prevalence of hypertension was 8.0% (95%CI 5.0–11.0; I² = 97.6%), 9.3% (95%CI 5.6–13.6; I² = 96.4%) in males and 6.5% (95%CI 4.2–9.1; I² = 94.2%) in females. The meta-regression failed to identify the causes of the heterogeneity among studies,” the reviewers explained.

To be included, the studies were required to meet the following criteria:

• Hypertension at or above the 95th percentile for sex, height and age (10 to 17 years) or above 140 x 90 millimeters of mercury (mmHg);
• Study population included adolescents aged 18 to 19 years;
• Public and private schools were included in the same study;
• Publication date, language or status limitations were not applied.

“Despite the differences found in the methodologies of the included studies, the results of this systematic review indicate that hypertension is prevalent in the Brazilian adolescent school population. For future investigations, we suggest the standardization of techniques, equipment, and references, aiming at improving the methodological quality of the studies,” the authors concluded. However, the meta-regression analysis failed to identify the heterogeneity among studies.

Conclusion

“High blood pressure has a high prevalence in the adolescent population in Brazil. Future investigations need to standardize techniques and references, besides analyzing important factors for this population such as nutritional status, age, stages of sexual maturity and adolescence, to mitigate the high heterogeneity,” the authors noted in their conclusion.