Hypertension in young adults: An under-estimated problem

To study the prevalence of hypertension and "white coat hypertension" in young adult Asian males, and identify the associated risk factors. Population-based descriptive analysis of 3,352 Singapore military conscripts presenting consecutively for medical screening, followed by case-control study of subjects with elevated blood pressure. A standard protocol for assessing elevated blood pressure, 24-hour ambulatory monitoring and detailed interviews were performed. Main study outcomes are prevalence rate of hypertension and "white coat hypertension", mean blood pressure readings, and adjusted odds ratios for associated variables. Prevalence of hypertension and "white coat hypertension" was 1.6% (95% CI 1.2, 2.0) and 2.0% (95% CI 1.5, 2.5) respectively. Twenty-four-hour ambulatory monitoring was required to differentiate the two conditions, with a fall of 22.5 mmHg (95% CI 19.7, 25.3) observed between first visit and day-time ambulatory mean systolic blood pressures. There was strong association between hypertension and obesity (adjusted odds ratio using Body Mass Index: 1.19, p