Oral contraceptive use in girls and alcohol consumption in boys are associated with increased blood pressure in late adolescence

Abstract

Aims:

Lifestyle behaviours established during adolescence may adversely affect blood pressure (BP) and contribute to gender differences in cardiovascular risk in adulthood. We aimed to assess the association of health behaviours with BP in adolescents, using data from the Western Australian Pregnancy (Raine) Study.

Methods:

Cross-sectional analysis on 1248 Raine Study adolescents aged 17 years, to examine associations between lifestyle factors and BP.

Results:

Boys had 8.97 mmHg higher systolic BP, as compared with girls. The 30% of girls using oral contraceptives (OC) had 3.27 and 1.74 mmHg higher systolic and diastolic BP, respectively, compared with non-users. Alcohol consumption in boys, increasing body mass index (BMI) and the sodium-potassium ratio were associated with systolic BP. We found a continuous relationship between BMI and systolic BP in both genders; however, the gradient of this relationship was significantly steeper in boys, compared with girls not taking OC. In boys, systolic BP was 5.7 mmHg greater in alcohol consumers who were in the upper quartile of BMI and the urinary sodium-potassium ratio compared with teetotallers in the lowest quartile. In girls, systolic BP was 5.5 mmHg higher in those taking OC, in the highest BMI and urinary sodium-potassium ratio quartile as compared to those not taking the OC pill and in the lowest quartile.

Conclusion:

In addition to gender-related differences in the effects of adiposity on BP, we found lifestyle-related health behaviours such as high salt intake for both sexes, consumption of alcohol in boys, and OC use in girls were important factors associated with BP measurements in late adolescence. This suggests that gender-specific behavioural modification in adolescence may prevent adult hypertension.

Keywords

Oral contraceptives alcohol consumption blood pressure adolescence gender differences hypertension risk factors lifestyle salt consumption body mass index

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References

Falkner

Lurbe

Schaefer

. High blood pressure in children: Clinical and health policy implications. J Clin Hypertens 2010;12: 261–276.

Paradis

Lambert

O'Loughlin

. Blood pressure and adiposity in children and adolescents. Circulation 2004; 110: 1832–1838.

Tirosh

Iris Shai

Afek

. Adolescent BMI trajectory and risk of diabetes versus coronary disease. N Engl J Med 2011;364: 1315–1325.

Dasgupta

O'Loughlin

Chen

. Emergence of sex differences in prevalence of high systolic blood pressure: Analysis of a longitudinal adolescent cohort. Circulation 2006; 114: 2663–2670.

Syme

Abrahamowicz

Leonard

. Sex differences in blood pressure and its relationship to body composition and metabolism in adolescence. Arch Ped Adol Med 2009; 163: 818–825.

Chasan-Taber

Willett

Manson

JAE

. Prospective study of oral contraceptives and hypertension among women in the United States. Circulation 1996; 94: 483–489.

Murayama

Matsunaga

AYU

Tangbanluekal

. Effects of oral contraceptive use on body mass index and blood pressure among female villagers in north–east Thailand. J Biosoc Sci 2003; 35: 243–261.

Newnham

Evans

Michael

. Effects of frequent ultrasound during pregnancy: A randomised controlled trial. Lancet 1993; 342: 887–891.

Huang

Burke

Newnham

. Perinatal and childhood origins of cardiovascular disease. Int J Obesity 2006; 31: 236–244.

10.

Cole

Bellizzi

Flegal

. Establishing a standard definition for child overweight and obesity worldwide: International survey. BMJ 2000; 320: 1240–1240.

11.

Falkner

Daniels

. Summary of the fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Hypertension 2004; 44: 387–388.

12.

Socioeconomic Indexes for Areas. Canberra: Australian Bureau of Statistics, 2001.

13.

National Physical Activity Guidelines for Adults. Canberra: Department of Health and Ageing, Commonwealth of Australia, 2005.

14.

Ambrosini

Oddy

Robinson

. Adolescent dietary patterns are associated with lifestyle and family psycho-social factors. Pub Health Nut 2009; 12: 1807–1815.

15.

Royston

. Multiple imputation of missing values. Stata J 2004; 4: 227–241.

16.

Israeli

Schochat

Korzets

. Prehypertension and obesity in adolescents: A population study. Am J Hypertens 2006; 19: 708–712.

17.

Wang

Necheles

Carnethon

. Adiposity measures and blood pressure in Chinese children and adolescents. Arch Dis Child 2008; 93: 738–744.

18.

Huang

De Klerk

Mori

. Differential relationships between anthropometry measures and cardiovascular risk factors in boys and girls. Int J Ped Obes 2011;6: e271–e282.

19.

Nawrot

Hond

Fagard

. Blood pressure, serum total cholesterol and contraceptive pill use in 17-year-old girls. J Cardiovasc Risk 2003; 10: 438–442.

20.

Jerez

Coviello

. Alcohol drinking and blood pressure among adolescents. Alcohol 1998; 16: 1–5.

21.

Milligan

RAK

Burke

Dunbar

. Associations between lifestyle and cardiovascular risk factors in 18-year-old Australians. J Adoles Health 1997; 21: 186–195.

22.

Van Leer

Seidell

Kromhout

. Differences in the association between alcohol consumption and blood pressure by age, gender, and smoking. Epidemiol 1994; 5: 576–582.

23.

Marrero

Macgregor

. Salt and blood pressure in children and adolescents. J Hum Hypertens 2007; 22: 4–11.

24.

Rodriguez

Labarthe

Huang

. Rise of blood pressure with age. New evidence of population differences. Hypertension 1994; 24: 779–785.

25.

Sacks

Svetkey

Vollmer

. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. N Engl J Med 2001; 344: 3–10.

26.

Dubey

Oparil

Imthurn

. Sex hormones and hypertension. Cardiovasc Res 2002; 53: 688–708.

27.

Kaufman

Asuzu

Mufunda

. Relationship between blood pressure and body mass index in lean populations. Hypertension 1997; 30: 1511–1516.

28.

Bunker

Ukoli

Matthews

. Weight threshold and blood pressure in a lean black population. Hypertension 1995; 26: 616–623.

29.

Falaschetti

Hingorani

Jones

. Adiposity and cardiovascular risk factors in a large contemporary population of pre-pubertal children. Eur Heart J 2010;31: 3063–3072.

30.

Maximova

O'Loughlin

Paradis

. Declines in physical activity and higher systolic blood pressure in adolescence. Am J Epidemiol 2009; 170: 1084–1094.

31.

Trost

Pate

Sallis

. Age and gender differences in objectively measured physical activity in youth. Med Sci Sports Exer 2002; 34: 350–355.

32.

Owen

Nightingale

Rudnicka

. Physical activity, obesity and cardiometabolic risk factors in 9-to-10-year-old UK children of white European, South Asian and black African-Caribbean origin: The child heart and health study in England (CHASE). Diabetologia 2010;53: 1620–1630.

33.

Fasting

Nilsen

TIL

Holmen

. Life style related to blood pressure and body weight in adolescence: Cross sectional data from the Young-HUNT study, Norway. BMC Pub Health 2008; 8: 111–111.

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