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The Change in Blood Pressure during Pubertal Growth

Departments of Pediatrics (R.R.S.) and Medicine (G.J.E., C.S., W.T., J.H.P.) and the Regenstrief Institute (W.T.), Indiana University School of Medicine, and the Richard L. Roudebush Veterans Administration Medical Center (J.H.P.), Indianapolis, Indiana 46202

Address all correspondence and requests for reprints to: J. Howard Pratt, M.D., 541 Clinical Drive, Indianapolis, Indiana 46202-5111. E-mail: johpratt{at}iupui.edu.

Blood pressure (BP) in children may increase more during puberty. Using a cohort of children where BP and body size had been closely monitored, we compared the rates of change in BP during the 3-yr period before puberty, during puberty (4.5-yr period), and the 3-yr period after puberty. Because there was no specific staging information with respect to puberty, we used pubertal growth (PG) as a surrogate of puberty. The latter was determined from serial measurements of height. All subjects (n = 151) were followed from before the period of PG to the period after PG; none were related. An age-dependent increase in systolic BP in the pre-PG period was similar regardless of sex or race. During PG, systolic BP in males increased three to six times faster than in the pre-PG period. In females, systolic BP increased less than in males during PG but still increased two to four times faster than in the pre-PG period. The increase in males was significantly greater than in females (P < 0.001). Post-PG changes in BP were similar to changes in pre-PG BP. In summary, PG was associated with profound increases in systolic BP. There were noticeably greater increments in males than in females consistent with the emergence of the well known sexual dimorphism in BP.

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