Prevalence of adolescent hypertension and its associated risk factors in Benue State, Nigeria

Evidence indicates a global rise in pediatric hypertension (HTN) driven by body composition, physiological, demographic, and environmental factors, with low- and middle-income countries disproportionately affected. This cross-sectional study investigated the prevalence of HTN and determinants of resting blood pressure (BP) among adolescents in Benue State, Nigeria. This study involved 2,226 adolescents (males = 1,038; females = 1,188) aged 12–16 years. Participants were assessed for resting systolic BP (SBP) and diastolic BP (DBP), as well as physical characteristics including indices of general and abdominal adiposity, cardiorespiratory fitness, and leg power. The overall prevalence of systolic and diastolic HTN was 10.1% and 10.2%, respectively. Systolic HTN was more prevalent among females (12.6%) than males (7.1%). Among males, those from urban areas exhibited higher rates of both systolic and diastolic HTN compared to their rural counterparts. In females, urban–rural prevalence patterns for systolic HTN were similar to those of males, although rural females showed a higher prevalence of diastolic HTN than urban peers. Males with high waist circumference were 5.5 times more likely (95% CI = 1.5 - 20.1, p = 0.009) to have systolic HTN than normal peers, while the likelihood of a female adolescent with unfavorable WHtR having systolic HTN was 5.0 times (95% CI = 1.2 – 21.1, p = 0.020) that of her normal peer. Furthermore, a female adolescent with an unfavorable recovery DBP1 has a 1.8-fold increased likelihood of having diastolic HTN for each unit increase in DBP1. Overall, females and adolescents from urban areas demonstrated higher HTN prevalence than males and rural adolescents, respectively. Hypertension among Nigerian adolescents appears to be influenced by sex, location, body composition parameters, and recovery BP. Given its public health significance, periodic BP monitoring, healthy eating and promoting regular physical activity are essential for mitigating hypertension risk in this population.