Background: Creation of a hypertension risk stratification model and development of an algorithm to detect hypertension in teenagers.
Methods: The study group consisted of 690 middle and high school students, aged 15-17 years, from the metropolitan area of Warsaw, Poland. Information concerning family history and presence of risk factors for cardiovascular disease was gathered. Three-time blood pressure measurements were taken during at least two separate visits, which were at least a week apart, using the auscultatory method, according to standard procedures. Anthropometric measurements included: body weight, height, arm, hip and abdominal circumference, skin-fold thickness measured on the rear surface of an arm, below the inferior angle of the scapula and at the belly. Following indexes were determined: body mass index, waist to hip ratio (WHR), waist to height ratio, hip to height ratio.
Results: A logistic regression model, describing the risk of hypertension in adolescents aged 15-17 was invented. p(x) = (e^g(x))/(1+e^g(x)) where ĝ(x) = -0.097 × height+0.085 × weight+7.764 × WHR+1.312 × family hypertension. Family hypertension means presence of hypertension among members of the closest family. The formula was created, allowing the pre-selection of adolescents at risk of hypertension during screening. Next an algorithm for the detection of hypertension for practical use was proposed.
Conclusions: Body weight, WHR and incidence of hypertension in the family are the strongest predictors of hypertension in teenagers. Proposed screening algorithm can be a useful tool for selecting teenagers at risk of hypertension and in need of specialized diagnostics and care.
Keywords: hypertension in children; hypertension in teenagers; hypertension risk stratification; prediction of hypertension; primary hypertension.