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 The researchers followed almost 2.7 million teens over about two
decades starting when they were 17 years old, on average. Nearly
8,000 of the teens, or about 0.3 percent, had high blood pressure
but none had signs of kidney disease or damage.
By the end of the study period, about 2,200 people developed end
stage renal disease (ESRD), which is kidney damage so advanced that
patients typically need dialysis or a transplant to stay alive.
After researchers accounted for other factors that can contribute to
ESRD - like age, education levels and obesity – those with high
blood pressure, or hypertension, as teens were still twice as likely
to develop this chronic kidney disorder by middle age.
"Hypertension is associated with obesity and diabetes and both
contribute to the effect on the kidney," said senior study author
Dr. Ehud Grossman, dean of the Sackler Faculty of Medicine at
Tel-Aviv University in Israel.
"However, in our study we adjusted for these factors and elevated
blood pressure by itself was associated with future renal failure,"
Grossman said by email.
The doubled risk of ESRD in middle age held true even after
researchers excluded teens with severe hypertension.
Half of the teens with high blood pressure were overweight or obese,
and most were male. Yet the risk remained doubled for normal-weight
teens with high blood pressure as well.
The study wasn't designed to prove whether or how teen hypertension
might directly cause ESRD.
One limitation on the results is that researchers lacked data on
blood pressure during the follow-up period, which might impact the
adult risk of ESRD, the study authors note in JAMA Internal
Medicine.
"It is possible that high blood pressure and kidney failure are
consequences of the same catalyst - such as a genetic variant or an
undiagnosed kidney disease," said Dr. Amy Kogon of the Children's
Hospital of Philadelphia and the Perelman School of Medicine at the
University of Pennsylvania.
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"The important take-home message for parents and patients is to
maintain a lifestyle that reduces the risk of developing
hypertension," Kogon, who wasn't involved in the study, said by
email.
Both hypertension and ESRD are rare in young people, but parents
should still focus on prevention, said James Gangwisch, a researcher
at Columbia University Medical Center in New York City who wasn't
involved in the study. These conditions that were once seen almost
exclusively in adults are becoming more common at earlier ages, he
said by email.
"The fact that we are now seeing these conditions in adolescents is
troubling," Gangwisch said. "Behaviors such as getting adequate
physical activity, eating a healthy diet and getting sufficient
sleep can both prevent and treat hypertension."
When teens do develop high blood pressure, treating it quickly with
lifestyle changes and medication may help ward off future health
problems, said Dr. Csaba Kovesdy of the University of Tennessee
Health Science Center in Memphis.
"High blood pressure is easy to diagnose and relatively easy to
treat," Kovesdy, who wasn't involved in the study, said by email.
"While the risk of ESRD associated with hypertension is real,
treatment of high blood pressure is especially important for the
prevention of future strokes and heart attacks."
SOURCE: https://bit.ly/2VY4yrU JAMA Internal Medicine, online
February 25, 2019.
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