- Hypertension (HTN) in late adolescence is tied to a doubled risk for future end-stage renal disease (ESRD) regardless of overweight or HTN severity.
Why this matters
- Teenage hypertension is a growing public health issue in developed countries.
- Israeli cohort study of 2,658,238 healthy military candidates aged 16-19 years (mean, 17.4±0.5 years; 60.1% male) undergoing comprehensive medical evaluation.
- 7997 (0.3%) had established HTN (repeated measurements).
- Funding: None disclosed.
- Nearly half of hypertensive teenagers were overweight (20.1%) or obese (28.9%); the majority (90.5%) were male.
- Majority originated from North America/Europe (42.4%) or former U.S.S.R. (21.3%).
- 2189 teenagers later developed ESRD over a median 19.6-year follow-up (incidence rate, 3.9 per 100,000 person-years).
- Rate among those with HTN, 20.2 per 100,000 person-years.
- In unadjusted analysis, teenage HTN was tied to an increased risk for later ESRD (crude HR=5.07; 95% CI, 3.73-6.88).
- In multivariate analysis, HR for later ESRD was 1.98 (95% CI, 1.42-2.77) after adjustments for sex, age, education, BMI, and other sociodemographic variables.
- HR remained significant after excluding teenagers with severe HTN (HR=1.93; 95% CI, 1.37-2.70).
- ESRD risk remained doubled when analysis was restricted to nonoverweight teenagers with HTN (HR=2.11; 95% CI, 1.05-4.24).
- Retrospective design.