Urban adolescent gender differences in risk of hypertension and overweight/obesity

Objectives. School district Wellness Programs mandate screening of body mass index (BMI) and blood pressure, yet data are not systematically analyzed. We examined school based health clinic data to determine risk of hypertension in 9th graders by BMI status. Methods. Health data (2008-2009) were extracted from one school-based health clinic (n=1,122) in an urban, low-income, multi-ethnic high school. Logistic regression estimated adjusted odds ratios. Results. Mutually exclusive overweight (85th-95th percentile) prevalence was 20.6%, and obesity (>95th percentile) was 25.2%. Overall hypertension prevalence was 29.4% for systolic, 10.0% for diastolic, 5.5% for both, and significantly higher in boys than girls (p < 0.05). Odds ratios for systolic or diastolic hypertension were not significant in overweight boys or girls after adjustment for age and ethnicity. However, odds ratios for systolic, diastolic, or presence of both types of hypertension were highly significant for both obese boys and girls, ranging from 3.8 to 7.2 after adjustment. Boys were more likely to have higher risk for systolic hypertension, and girls were more likely have higher risk of diastolic or the presence of both types of hypertension. Conclusions. While it is well-known obesity increases the risk of hypertension, these data illustrate significant risk at a very early age. The onset of hypertension in youth may contribute to an accelerated course of cardiovascular disease and target-organ damage in young adulthood. School districts should begin to use data from their Wellness Initiatives to better inform their health education/literacy curriculum and to design more targeted interventions for adolescents.