Adolescent Hypertension Is Associated With Stroke in Young Adulthood: A Nationwide Cohort of 1.9 Million Adolescents

Abstract

BACKGROUND: Adult hypertension is a well-established risk factor for stroke in young adults (aged <55 years), and the effects are even more deleterious than at an older age. However, data are limited regarding the association between adolescent hypertension and the risk of stroke in young adulthood. METHODS: A nationwide, retrospective cohort study of adolescents (aged 16–19 years) who were medically evaluated before compulsory military service in Israel during 1985 to 2013. For each candidate for service, hypertension was designated after constructed screening, and the diagnosis was confirmed through a comprehensive workup process. The primary outcome was ischemic and hemorrhagic stroke incidence as registered at the national stroke registry. Cox proportional-hazards models were used. We conducted sensitivity analyses by excluding people with a diabetes diagnosis at adolescence or a new diabetes diagnosis during the follow-up period, analysis of adolescents with overweight, and adolescents with baseline unimpaired health status. RESULTS: The final sample included 1 900 384 adolescents (58% men; median age, 17.3 years). In total, 1474 (0.08%) incidences of stroke (1236 [84%] ischemic) were recorded, at a median age of 43 (interquartile range, 38–47) years. Of these, 18 (0.35%) occurred among the 5221 people with a history of adolescent hypertension. The latter population had a hazard ratio of 2.4 (95% CI, 1.5–3.9) for incident stroke after adjustment for body mass index and baseline sociodemographic factors. Further adjustment for diabetes status yielded a hazard ratio of 2.1 (1.3–3.5). We found similar results when the outcome was ischemic stroke with a hazard ratio of 2.0 (1.2–3.5). Sensitivity analyses for overall stroke, and ischemic stroke only, yielded consistent findings. CONCLUSIONS: Adolescent hypertension is associated with an increased risk of stroke, particularly ischemic stroke, in young adulthood.

Body mass index and migraine in adolescence: A nationwide study

“…Analyses were stratified by sex given the interaction between BMI categories, sex, and migraine. Models were unadjusted or adjusted to pre-specified variables that we have previously included in studies that examined the association between BMI and several other diseases (10,13,14,17). These variables included residential socio-economic status, education, and cognitive performance.…”

“…Sociodemographic data were obtained based on routine reports on examinees from various governmental ministries. Residential socio-economic status was reported from the Israeli Central Statistical Bureau on a 1-10 scale that was divided into three ordinal groups (low, medium, and high), as previously described (13). Education level was dichotomized by a cutoff of 11 years based on data received from the Israeli Ministry of Education, as this represents the maximum school instruction that could be attained at the time of assessment (14).…”

Advancing Non-Cuff Hypertension Detection: Leveraging 1D Convolutional Neural Network and Time Domain Physiological Signals

“…High blood pressure, or hypertension (HT), is a significant global health issue. It is associated with conditions such as strokes [1] and diabetes [2] and is acknowledged Advancing Non-Cuff Hypertension Detection: Leveraging 1D Convolutional Neural Network and Time Domain Physiological Signals as a significant risk factor for sudden cardiac death [3]. Between 1990 and 2019, there was a significant increase in the prevalence of HT among individuals aged 30-79 years.…”