Hypertension among adolescents in Nigeria: A retrospective study of adolescent university freshmen

Purpose: The burden of hypertension is rising both globally and in Africa specifically. We determined the prevalence of hypertension and the risk factors for clinical hypertension in a population of new university intakes over a 4-year period. Methods: We analyzed retrospectively, the records of 6980 older adolescents (15-19 years). We used population-specific metrics to categorize blood pressure (BP) based on the 2017 Clinical Practice Guidelines by the American Academy of Pediatrics. Results: The overall prevalence of high BP in our study was 25.1% [95% confidence interval (CI) 24.1-26.2] for elevated BP, 19.8% (95% CI 18.9-20.8) for stage 1 hypertension, and 5.5% (95% CI 5.0-6.1) for stage 2 hypertension. The prevalence of stage 2 hypertension was 8.7% (7.5-9.5) among the male participants and 3.2% (95% CI 2.7-3.2) among the female participants (p < 0.001). The multivariate analyses demonstrated an increased risk of high levels of BP (p < 0.001) with age (1.21: 95% CI 1.16-1.26), waist-to-height ratio (WHtR) (1.05: 95% CI 1.04-1.05), z-score for body mass index (BMI) (1.47: 95% CI 1.41-1.54), and hemoglobin concentration (1.10: 95% CI 1.09-1.12). It demonstrated a reduced risk of high levels of BP (p < 0.001) being female (0.35: 95% CI 0.32-0.39). Conclusions: Hypertension, its risk factors and the risk of cardiovascular diseases in later life are prevalent in our Nigerian adolescent population. There is, therefore, a need for the development, evaluation and implementation of context-appropriate strategies and interventions to mitigate the risk of hypertension among adolescents, and cardiovascular diseases later in life.