Risk Factors For Elevated Blood Pressure Research Articles

Association between urinary sodium-to-potassium ratio, elevated blood pressure phenotypes and microalbuminuria: Tehran Lipid and Glucose Study.

This cross-sectional study investigated the associations between urinary sodium (UNa) to potassium (UK) ratio, different phenotypes of elevated blood pressure (BP), and microalbuminuria (MAU) in a cohort of the Tehran Lipid and Glucose Study (TLGS). Adult participants (n = 1782, mean age of 43.0 ± 13.7 years and 46.0% were men) were recruited (2015-2017) for measurements of spot urinary metabolites, i.e., Na, K, creatinine (Cr), microalbumin, and BP. Multinomial logistic regression was used to estimate the relative risk ratios (RRR) of elevated BP phenotypes [i.e., isolated systolic (ISH), diastolic (IDH), and systolic-diastolic (SDH) hypertension], and binary logistic regression was used to estimate odds ratios (ORs) of MAU across quintile categories and per each SD-increment of UNa-K ratio. Mean UNa, UK, and its ratio was 137 ± 57.4, 72.1 ± 36.6 mmol/L, and 2.31 ± 1.41, respectively. Subjects with UNa-K > 3.14 had higher prevalence of ISH (3.4 vs. 1.1%), SDH (11.0 vs. 6.2%), and MAU (14.1 vs. 6.2%) (P for all < 0.05). Highest compared to the lowest UNa-K ratio values (> 3.14 vs. <1.23) was associated with an increased probability of SDH (RRR = 1.79, 95% CI 1.09-3.19) and MAU (OR = 2.53, 95% CI 1.23-5.20). Every 1 SD-increment of the UNa-K ratio was associated with a 29 and 38% increased chance of having SDH and MAU, respectively. Our findings imply that a high UNa-K ratio may be a potential risk factor for elevated BP and renal dysfunction.

Elevated Blood Pressure and Stage 1 Hypertension in Pregnancy: A Review of the Literature.

Maternal and perinatal morbidity/mortality is significantly increased in pregnancies complicated by hypertension. The definition of hypertension has recently changed with the addition of 2 categories: elevated blood pressure (BP) and stage 1 hypertension. Should these categories be considered during pregnancy? The aim of this study was to analyze the impact of the new hypertensive categories of elevated BP and stage 1 hypertension on maternal/perinatal outcomes. Literature search of PubMed, Web of Science, and CINAHL search was undertaken. Citations were limited to the past 20 years. Of the 333 articles identified, 26 articles were the basis of this review. In 2017, new guidelines on the diagnosis and management of hypertension were published. Prepregnancy hypertension was replaced by elevated BP (systolic BP 120-129 mm Hg and diastolic BP <80 mm Hg) and stage 1 hypertension (systolic BP 130-139 mm Hg and diastolic BP 80-89 mm Hg). The risk factors for elevated BP and stage 1 hypertension are similar to chronic hypertension (CHTN) risk factors, diagnosed by BP readings before pregnancy or before 20 weeks' gestation. Patients with elevated BP and stage 1 hypertension are at increased risk for hypertensive disorders of pregnancies compared with normal patients. Treatment strategies for elevated BP and stage 1 hypertension are uncertain. Before 2017, these patients would not have been considered hypertensive and no guidelines existed. Elevated BP and stage 1 hypertension increase the number of women labeled with hypertension in pregnancy. These women are at increased risk for adverse perinatal and maternal outcomes. There are currently no firm guidelines on management during pregnancy.

Hypertension Prevalence Based on Three Separate Visits and Its Association With Obesity Among Chinese Children and Adolescents.

Background: Clinical practice guidelines recommended that hypertension in children and adolescents should be defined based on elevated blood pressure (BP) on at least three separate occasions. Therefore, in the present study, we aimed to estimate the prevalence of hypertension based on three separate visits among Chinese children and adolescents and to examine its relationship with obesity.Methods: A school-based cross-sectional survey was performed in children and adolescents in Jinan, China between September 2012 and September 2014. A total of 7,832 children and adolescents aged 6–17 years were included. Anthropometric data and BP were measured by trained examiners. Elevated BP was defined as BP ≥ 95th percentile for age and sex based on the Chinese reference data. Participants with elevated BP at the first visit underwent a second visit 2 weeks later, and a third visit was conducted if BP was still high at the second visit. Hypertension was defined as having an elevated BP at all three visits. Obesity was defined in three ways by using body mass index, waist circumference, and waist-to-height ratio.Results: The prevalence of elevated BP decreased substantially across three separate visits, with the prevalence of 17.2, 8.6, and 4.9%, respectively. Obesity was an independent risk factor for elevated BP during each visit. Based on the body mass index, obesity was associated with higher risk of elevated BP, with the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of 8.6 (6.8–11.0), 12.5 (9.1–17.3), and 14.0 (8.9–22.2), respectively, at the first, second and third visit. The ORs of elevated BP were similar in association with obesity defined by waist circumference or waist-to-height ratio.Conclusions: The prevalence of hypertension based on three visits was ~5% in Chinese children and adolescents. There was a dose-response relationship between obesity and elevated BP across three visits.

Increased prevalence of elevated blood pressures in HIV-infected children, adolescents and young adults.

HIV-infected children and young adults have cardiovascular disease risk factors reflecting chronic infection and the effects of combination antiretroviral (ARV) therapy. We thus sought to characterize the prevalence of and risk factors for high blood pressure (HBP) in this population. Retrospective chart review classified subjects aged 2-25 years based on a single clinic blood pressure (BP) reading as normal BP, pre-HBP or HBP. Variables suspected to contribute to elevated BP were compared including body mass index, tobacco use, medical comorbidities, ARV or other medication use, dyslipidemia, ethnicity and family history. In all, 47 of 266 subjects (18%) were found to have HBP. Among children and adolescents aged 2-17 years, 21 of 107 (20%) had HBP. Comorbidities believed to elevate BP, such as polycystic ovarian syndrome, obstructive sleep apnea or cocaine exposure, were significant risk factors for elevated BP, with 35% of subjects with these comorbidities having HBP, compared with 16% of subjects without (P = 0.01). Male gender and tobacco use were also risk factors associated with elevated BPs. HBP was more common in overweight subjects (26%) than not overweight (15%) but did not reach statistical significance (P = 0.15). ARV medication use and higher HIV-1 RNA were not associated with HBP. Our finding of 20% prevalence of HBP in a cohort of HIV-infected children represents a potentially alarming figure. The explanation for this finding is unclear, but even if it is because of comorbid conditions, the life-long cardiovascular risks associated with HIV infection and its management mandate the need for closer monitoring and possibly treatment of elevated BP in this population.

Blood pressure evaluation in children treated with laser surgery for twin-twin transfusion syndrome at 2-year follow-up

Twin survivors of twin-twin transfusion syndrome (TTTS) may be at risk for early onset of cardiovascular disease. The aim of this study was to determine prevalence and risk factors for elevated blood pressure (BP) among children treated with selective laser photocoagulation of communicating vessels. Data were prospectively collected from surviving children treated for TTTS with laser surgery from 2008 through 2010. Systolic BP (SBP) and diastolic BP (DBP) were obtained from 91 child survivors at age 24 months (±6 weeks) and evaluated based on age, sex, and height percentile. BP percentiles were calculated for each patient and categorized as normal (<95%) or abnormal (>95%). Clinical variables were evaluated using multilevel regression models to evaluate risk factors for elevated BP. BP was categorized as normal in 38% and abnormal in 62% of twin survivors based on percentile for sex, age, and height; a comparable distribution was found for DBP elevation. There were no differences between donor and recipient twins for absolute SBP and DBP or BP classification. In a multivariate analysis, significant risk factors for higher SBP included prematurity (β -0.54; 95% confidence interval [CI], -0.99 to -0.09; P = .02), higher weight percentile (β 0.24; 95% CI, 0.05-0.42; P = .01), and presence of cardiac disease (β 0.50; 95% CI, 0.10-0.89; P = .01). Prematurity was also a significant risk for abnormal DBP (odds ratio, 0.89; 95% CI, 0.80-1.00; P = .05). Child survivors of TTTS had elevated SBP and DBP measurements at 2 years of age, with no differences seen between former donor and recipient twins. Prematurity may be a risk factor for elevated BP measurements in this population. Future studies are warranted to ascertain whether these cardiovascular findings persist over time.

Household Air Pollution and Children's Blood Pressure

To the Editor: Childhood blood pressure (BP) is an important predictor of hypertension and cardiovascular risk later in life1; risk factors for elevated BP in children remain mostly unknown. Ambient air pollution is associated with impaired vascular health, oxidative stress, and systemic inflammation in children.2 Limited evidence suggests that household air pollution is associated with higher BP in adult women,3–5 but this relationship has not been studied in children. Half the world's population uses biomass and coal for energy6; thus, even a small effect of household air pollution on BP in childhood could have large cardiovascular implications. We investigated the association between exposure to household air pollution from biomass combustion and BP in Chinese children. We recruited school-aged children from 180 rural households cooking with biomass in Yunnan, China. Detailed information on the study population, exposure assessment, and quality control is published elsewhere.7 Participants wore a small backpack containing equipment to measure personal exposure to particles <2.5 μg in aerodynamic diameter (particulate matter [PM]2.5) over a 24-hour period. PM2.5 samples were analyzed for mass and black carbon (BC) (eAppendix 1, https://links.lww.com/EDE/A592). We measured children's BP before and after pollution exposure measurement, using an automated device (Omron-705). We also collected household sociodemographic and health information, including caffeine intake, exposure to cigarette smoke, physical activity, and 24-hour salt and monosodium glutamate intake, and we measured each child's height and weight. Mother's BP was assessed in a 40% subsample (eAppendix 2, https://links.lww.com/EDE/A592). We investigated the associations between personal PM2.5 and BC exposures and BP using one- and two-pollutant multivariate regression models. Pollution measures were transformed to the natural log scale to account for their skewedness toward high values (eAppendix 3, https://links.lww.com/EDE/A592). We enrolled 240 children (47% girls). Mean age was 10.3 years (95% confidence interval: 10.0–10.6; range: 5–14 years), average body mass index was 15.3 kg/m2 (15.0–15.6), and 85% lived with a smoker (eTable 1, https://links.lww.com/EDE/A592). Personal 24-hour PM2.5 exposure ranged from 14 to 393 μg/m3 (geometric mean = 53 μg/m3 [46–61]). BC exposure ranged between 2.0 and 9.6 μg/m3 (geometric mean = 3.2 μg/m3 [3.1–3.3]). PM2.5 and BC exposures were moderately correlated (Pearson r = 0.41). In the single-pollutant multivariate regression models, a 1-ln(μg/m3) increase in PM2.5 was associated with small decreases in systolic BC (−1.8 mmHg [95% confidence interval: −3.6, 0.1]) and diastolic BC (−0.5 mmHg [−2.1 to 1.2]). Similarly, a 1-ln(μg/m3) increase in BC was also associated with small decreases in systolic BC (−2.2 mmHg [−5.4 to 1.0]) and diastolic BC (−0.4 mmHg [−3.3 to 2.6]). In two-pollutant models, the effect of PM2.5 exposure on BP was largely unchanged; however, the effect of BC was greatly weakened (Table). Sensitivity analyses included adjustment for maternal BP, restricting the analysis to smaller age-groups, and transforming BP into quantiles; none of these affected the qualitative interpretation of our results (eAppendix 4, https://links.lww.com/EDE/A592).Table: Multivariate Adjusted Associations of Personal PM2.5 and Black Carbon Exposure With Blood Pressure Using One- and Two-pollutant ModelsaWe found that increased PM2.5 and BC exposures were not associated with higher BP among children in households cooking with biomass. Our findings do not support our previous study of older women in this setting, showing a positive relationship between PM exposure and BP. Possible explanations include the lower levels and shorter durations of PM exposure among children compared with adult women7 (eAppendix 5, https://links.lww.com/EDE/A592). Older women would be more likely than young children to experience a resetting of BP-regulating mechanisms to higher levels, as a result of repeated acute increases in BP after PM inhalation. We also cannot rule out the possibility of residual confounding by difficult-to-measure or unmeasured covariates in this cross-sectional study. Future longitudinal studies could advance our understanding of the vascular effects of household air pollution in children and should incorporate measures of PM pollution exposure and BP over a span of years. Jill Baumgartner Institute on the Environment College of Food, Agricultural and Natural Resource Sciences University of Minnesota St. Paul, MN [email protected] Yuanxun Zhang College of Resources and Environment Graduate University of the Chinese Academy of Sciences Beijing, China James J. Schauer Department of Civil and Environmental Engineering College of Engineering University of Wisconsin Madison, WI Majid Ezzati MRC-HPA Centre for Environment and Health Department of Epidemiology and Biostatistics School of Public Health, Imperial College London, United Kingdom Jonathan A. Patz Global Health Institute School of Medicine and Public Health University of Wisconsin Madison, WI Leonelo E. Bautista Department of Population Health Sciences School of Medicine and Public Health University of Wisconsin Madison, WI

Indoor Air Pollution and Blood Pressure in Adult Women Living in Rural China

Background: Almost half of the world’s population uses coal and biomass fuels for domestic energy. Limited evidence suggests that exposure to air pollutants from indoor biomass combustion may be associated with elevated blood pressure (BP).Objective: Our aim was to assess the relationship between air pollution exposure from indoor biomass combustion and BP in women in rural China.Methods: We measured 24-hr personal integrated gravimetric exposure to fine particles < 2.5 µm in aerodynamic diameter (PM2.5) and systolic BP (SBP) and diastolic BP (DBP) in the winter and summer among 280 women ≥ 25 years of age living in rural households using biomass fuels in Yunnan, China. We investigated the association between PM2.5 exposure and SBP and DBP using mixed-effects models with random intercepts to account for correlation among repeated measures.Results: Personal average 24-hr exposure to PM2.5 ranged from 22 to 634 µg/m3 in winter and from 9 to 492 µg/m3 in summer. A 1-log-µg/m3 increase in PM2.5 exposure was associated with 2.2 mm Hg higher SBP [95% confidence interval (CI), 0.8 to 3.7; p = 0.003] and 0.5 mm Hg higher DBP (95% CI, –0.4 to 1.3; p = 0.31) among all women; estimated effects varied by age group. Among women > 50 years of age, a 1-log-µg/m3 increase in PM2.5 exposure was associated with 4.1 mm Hg higher SBP (95% CI, 1.5 to 6.6; p = 0.002) and 1.8 mm Hg higher DBP (95% CI, 0.4 to 3.2; p = 0.01). PM2.5 exposure was positively associated with SBP among younger women, but the association was not statistically significant.Conclusion: PM2.5 exposure from biomass combustion may be a risk factor for elevated BP and hence for cardiovascular events. Our findings should be corroborated in longitudinal studies.

Anthropometric risk factors for elevated blood pressure in adolescents in Turkey aged 11–17

To investigate the relationship between anthropometric parameters and elevated blood pressure in adolescents, we measured blood pressure (BP), height, weight, triceps skinfold (TSF) thickness, waist circumference (WC), and mid-upper-arm circumference (MUAC) in 2,860 student volunteers aged 11-17 years in Kayseri, Turkey. Waist-to-height ratio (WHtR), waist-to-arm-span ratio (WASR), body mass index (BMI), arm-fat area (AFA), and fat percentage (FP) were also calculated. Participants were divided into two groups: hypertensive [systolic blood pressure (SBP) or diastolic blood pressure (DBP) ≥ 95th percentiles, n = 246] and normotensives (SBP or DBP < 95th percentiles, n = 2614). Multiple logistic regression models were produced within these groups for the examined risk factors, and cutoff points were investigated for SBP or DBP ≥ 95th percentiles using receiver operating characteristics (ROC) analysis. BMI, WC, WHtR, WASR, MUAC, and BMI had statistically significant cutoffs among boys. Whereas BMI, WHtR, WASR, WC, MUAC, AFA, and TSF were statistically significant for girls younger than 15, only BMI and WC were statistically significant for participants older than 15. The independent risk factors for elevated BP were determined according to BMI and WC. Although several anthropometric measurements were significant in our participants, BMI and WC were significant among all participants irrespective of age and sex.

ASH position paper: Dietary approaches to lower blood pressure

A substantial body of evidence has implicated several aspects of diet in the pathogenesis of elevated blood pressure (BP). Well-established risk factors for elevated BP include excess salt intake, low potassium intake, excess weight, high alcohol consumption, and suboptimal dietary pattern. African Americans are especially sensitive to the BP-raising effects of excess salt intake, insufficient potassium intake, and suboptimal diet. In this setting, dietary changes have the potential to substantially reduce racial disparities in BP and its consequences. In view of the age-related rise in BP in both children and adults, the direct, progressive relationship of BP with cardiovascular-renal diseases throughout the usual range of BP, and the worldwide epidemic of BP-related disease, efforts to reduce BP in nonhypertensive as well as hypertensive individuals are warranted. In nonhypertensives, dietary changes can lower BP and delay, if not prevent, hypertension. In uncomplicated stage I hypertension, dietary changes serve as initial treatment before drug therapy. In hypertensive individuals already on drug therapy, lifestyle modifications can further lower BP. The current challenge is designing and implementing effective clinical and public health interventions that lead to sustained dietary changes among individuals and more broadly in the general population.

ASH position paper: Dietary approaches to lower blood pressure

A substantial body of evidence has implicated several aspects of diet in the pathogenesis of elevated blood pressure (BP). Well-established risk factors for elevated BP include excess salt intake, low potassium intake, excess weight, high alcohol consumption, and suboptimal dietary pattern. African Americans are especially sensitive to the BP-raising effects of excess salt intake, insufficient potassium intake, and suboptimal diet. In this setting, dietary changes have the potential to substantially reduce racial disparities in BP and its consequences. In view of the age-related rise in BP in both children and adults, the direct, progressive relationship of BP with cardiovascular-renal diseases throughout the usual range of BP, and the worldwide epidemic of BP-related disease, efforts to reduce BP in nonhypertensive as well as hypertensive individuals are warranted. In nonhypertensives, dietary changes can lower BP and delay, if not prevent, hypertension. In uncomplicated stage I hypertension, dietary changes serve as initial treatment before drug therapy. In hypertensive individuals already on drug therapy, lifestyle modifications can further lower BP. The current challenge is designing and implementing effective clinical and public health interventions that lead to sustained dietary changes among individuals and more broadly in the general population.

ASH Position Paper: Dietary Approaches to Lower Blood Pressure

A substantial body of evidence has implicated several aspects of diet in the pathogenesis of elevated blood pressure (BP). Well-established risk factors for elevated BP include excess salt intake, low potassium intake, excess weight, high alcohol consumption, and suboptimal dietary pattern. African Americans are especially sensitive to the BP-raising effects of excess salt intake, insufficient potassium intake, and suboptimal diet. In this setting, dietary changes have the potential to substantially reduce racial disparities in BP and its consequences. In view of the age-related rise in BP in both children and adults, the direct, progressive relationship of BP with cardiovascular-renal diseases throughout the usual range of BP, and the worldwide epidemic of BP-related disease, efforts to reduce BP in nonhypertensive as well as hypertensive individuals are warranted. In nonhypertensives, dietary changes can lower BP and delay, if not prevent, hypertension. In uncomplicated stage I hypertension, dietary changes serve as initial treatment before drug therapy. In hypertensive individuals already on drug therapy, lifestyle modifications can further lower BP. The current challenge is designing and implementing effective clinical and public health interventions that lead to sustained dietary changes among individuals and more broadly in the general population.

Blood Pressure Screening of School Children in a Multiracial School District: The Healthy Kids Project

There are few studies of the prevalence of elevated blood pressure (BP) that include American Indian school children. Therefore, the intent of this study was to examine the relationships between BP and risk factors in a multiracial, predominantly American Indian, school district. A total of 1,829 American Indian, white, Hispanic, and African American students, 5-17 years old, were included in this study. The mean of two BP measurements, taken at the initial screening with an electronic BP monitor, were categorized as normal, prehypertensive, or hypertensive using the 2004 Fourth Report BP screening recommendations. Prevalence of prehypertensive and hypertensive BP measurements by race, gender, age, and body mass index (BMI) were determined, and their associations analyzed with logistic regression. The prevalence of prehypertensive measurements was 16.7% and prevalence of hypertensive measurements was 13.8% at first screen. Obesity was a risk factor for elevated BP for females and males (adjusted odds ratio (OR) = 4.01 and 4.33, respectively). Older age was also significantly associated with prehypertensive and hypertensive BP measurements, especially among males (adjusted OR = 6.91). Among females, American Indian race was protective against elevated BP (adjusted OR = 0.61). Obesity was consistently associated with an increased risk for elevated BP. American Indian race was associated with decreased risk of elevated BP measurements in females. The high prevalence of obesity-related hypertensive measurements in this population that includes American Indian children was similar to levels found in other multiracial populations of school children when using BP measurements from a single assessment.

The influence of socioeconomic status and birth weight on blood pressure of Indonesian pre-pubertal children

Background It has been shown that elevated blood pressure (BP)in childhood contributes to the development of coronary arterydisease, cerebrovascular accidents, heart failure, and renal failurein adults. There is also evidence of some correlations betweenchildhood BP and BP in adulthood. Obesity as well as low birthweight are a risk factors for elevated BP, both in children and inadults. Most epidemiological studies have also shown arelationship between high BP and socioeconomic status (SES).Objective To assess the influence of socioeconomic status andbirth weight on blood pressure of school-aged prepubertal childrenliving in Indonesia.Methods A cross-sectional survey on 2922 school-agedprepubertal children from the rural, poorurban and nonpoor urbancommunities was performed. Data on age, sex, stature, BMI, birthweight, systolic and diastolic BP were collected from all children.Results Overall and within every socioeconomic status group,blood pressures were positively associated with stature and bodymass index (BMI). Children from poor-socioeconomic families,i.e. rural and poor urban, had significantly lower height and BMI,and hence, in the unadjusted analyses, poor socioeconomic statuswas associated with lower systolic and diastolic BP. However, afteradjustment for age, sex, stature and BMI, rural children were foundto have significantly higher systolic BP compared to nonpoor urbanchildren, with regression coefficient (95% CI) of 1.19(0.42 to1.96). Birth weight was not associated with blood pressure inchildhood.Conclusion This study indicated that for a given stature and BMI,poor children had a higher systolic BP

Hypertension in pediatric patients on long-term dialysis: A report of the North American Pediatric Renal Transplant Cooperative Study (NAPRTCS)

Elevated blood pressure (BP) is frequent in children on long-term dialysis therapy. However, the prevalence of hypertension and status of BP control in these patients are lacking. Using the North American Pediatric Renal Transplantation Cooperative Study database, we determined the prevalence of hypertension and assessed risk factors for elevated BP during long-term dialysis therapy in children. The study cohort included 3,743 patients (age, 0 to 21 years). Uncontrolled hypertension is defined as BP equal to or greater than age-, sex-, and height-specific 95th percentiles; controlled hypertension was considered in children who were administered antihypertensive medications, but had BP less than the 95th percentile. A total of 76.6% of patients had either uncontrolled (56.9%) or controlled (19.7%) hypertension at baseline. Normotensive children at baseline had significant BP increases, whereas hypertensive children at baseline had significant BP decreases during the first year of dialysis therapy. BP did not change significantly after 1 year of dialysis therapy; 51% of patients had uncontrolled hypertension after 1 year of maintenance dialysis therapy. Logistic regression analysis shows that baseline hypertensive status and use of BP medications are both large significant risk factors for subsequent hypertension. Other risk factors include young age, acquired cause of renal failure, black race, initiation of dialysis therapy in 1992 to 1997, and hemodialysis as a mode of renal replacement therapy. Hypertension is very prevalent and difficult to control in children on dialysis therapy. Results also suggest that the initial months on maintenance dialysis therapy might be the window of opportunity when careful monitoring and aggressive management of hypertension would allow achieving BP control in these patients.

BODY COMPOSITION AND BLOOD PRESSURE IN BLACK PHILADELPHIA ADOLESCENTS

It is well established that weight is positively associated with blood pressure (BP) and that overweight is a significant risk factor for elevated BP. However, determining the relative importance of fat and lean body mass in explaining this phenomenon requires further investigation. This study examines the association between height (ht) and weight (wt) and BP at 7 years and body composition variables and BP during adolescence, using a representative sample of 600 black children from Philadelphia. The variables from the adolescent data are wt, ht, upper arm muscle circumference, and skinfold thicknesses and were analyzed using a mixed longitudinal design. The results from the 7 year and adolescent data show that wt, ht, and corrected wt for ht are all significantly correlated with BP. However, wt is more highly related to BP than the other variables. Further analyses of the adolescent data indicate that in those age and sex groups in which wt explains a significant proportion of BP variance, lean body mass is generally a more important contributor to this association than fat body mass. For example, for 13 and 14 year old males, the results of multiple regression analysis show that muscle circumference is the important contributor in systolic BP (adjusted beta weights .46 and .33, p < .01). Particularly in young adolescent males, lean body mass appears to be the component of wt which is associated with systolic BP. This work was supported by NHLBI Grant #HL - 19869.