Abstract Body: Background: Hypertension is a critical risk factor for cardiovascular diseases with a high prevalence in pediatric populations. However, the long-term effects of physical activity, sleep, and screen time on hypertension incidence in adolescents remain unclear.
Research Questions: How do long-term physical activity, sleep, and screen time influence the incidence of hypertension in adolescents within the Adolescent Brain Cognitive Development (ABCD) Study?
Aims: i) Investigate the long-term effects of physical activity, sleep patterns, and screen time on hypertension incidence in adolescents using Fitbit and self-reports.
Methods: Our analysis involved 1,702 adolescents (51.5% boys) from the ABCD study across 21 US cities, followed prospectively from 2018-2020 (T0) to 2020-2022 (T1), focusing on those with complete data on physical activity, sleep, screen time, and covariates (sex, age, waist circumference and social determinants). Hypertension was defined according to AAP guidelines. Movement behaviors were categorized as ≥ 60 minutes of moderate to vigorous physical activity daily, ≤ 2 hours of recreational screen time, and 9-11 hours of sleep. We estimated hypertension incidence and relative risks, examining the individual and joint additive effects of movement behaviors.
Results: At the T0, the mean age was 11.9 years, increasing to 14.1 years at T1. Adolescents who did not meet the screen time recommendations had higher hypertension prevalence (1.9%) and incidence (4.0%) compared to those who met the guideline (1.0% prevalence; 1.7% incidence). No significant differences were observed for sleep guideline adherence. Physical activity guideline adherence was associated with higher hypertension incidence (4.7% vs. 3.1%), but not prevalence (1.2% vs. 2.7%). Meeting two or more components of the 24-hour movement behavior guidelines was associated with significantly reduced hypertension risk (RR 0.31, 95% CI 0.09-0.98).
Conclusions: High screen time and not meet physical activity guideline are linked to increased hypertension risk in adolescents. Adhering two or more 24-hour movement behavior recommendations reduces this risk of hypertension, emphasizing the need for comprehensive and combined lifestyle interventions to promote cardiovascular health.