1. ¹Institute of Gastroenterology, Division of Internal Medicine, Hebrew University–Hadassah Medical Center, Jerusalem, Israel
2. ²Israel Defense Forces (IDF) Medical Corps, Tel-Aviv, Israel
3. ³Department of Nephrology and Hypertension, Meir Medical Center, Kfar-Saba, Israel
4. ⁴Division of Internal Medicine, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.

Correspondence: Eliezer Golan, Department of Nephrology and Hypertension, Meir Medical Center, 59 Tschernichovski St., Kfar-Saba 44281, Israel E-mail: golanel@clalit.org.il

Received 26 November 2006; Revised 10 December 2006; Accepted 25 January 2007.

Abstract

Background: It is estimated that by 2025, >1.5 billion adults worldwide will be hypertensive. Early identification of the population at risk would lead to improved utilization of preventive measures. We aimed to evaluate whether baseline body mass index (BMI) and blood-pressure (BP) values during adolescence (categorized according to the guidelines of the European Society of Hypertension–European Society of Cardiology) are of use in predicting the development of hypertension in young adulthood.

Methods: The study population consisted of 18,513 male regular army personnel who were initially recruited at 16.5 and 19 years of age between 1976 and 1996. The main outcome was the percentage of subjects who developed hypertension (140 systolic and 90 diastolic) at ages 26 to 45 years.

Results: At baseline, BP categories were: optimal, 5961 (32.2%); normal, 7998 (43.2%); and high normal, 4554 (24.6%). Moreover, 1377 (7.4%) were overweight (BMI 25–30 kg/m²), and 199 (1.1%) were obese (BMI >30 kg/m²). At follow-up, 2277 (12.3%) subjects developed hypertension. The percentages progressing to hypertension were 9.46%, 11.99%, and 16.56% for optimal, normal, and high-normal categories, respectively (P < .01). Odds ratios (OR) for the development of hypertension in the normal and high-normal categories versus optimal were 1.30 (95% confidence interval [CI], 1.22–1.39) and 1.79 (95% CI, 1.67–1.93), respectively, adjusted for age and BMI. The ORs for hypertension in overweight and obese versus normal BMI were 1.75 (95% CI, 1.66–1.86) and 3.75 (95% CI, 3.45–4.07), adjusted for age and BP. Of 9762 remaining at ideal BMI at follow-up, the percentages progressing to hypertension were 5.3%, 6.4%, and 9.5% for optimal, normal, and high normal (at baseline) (P < .01).

Conclusions: The risk of developing hypertension in young adulthood may be predicted by BP categories and BMI at adolescence.