The Influence of Adolescent Body Mass Index, Physical Activity, and Tobacco Use on Blood Pressure and Cholesterol in Young Adulthood

PurposeTo test the independent influences of adolescent tobacco use, physical activity/inactivity, and body mass index (BMI) on young adult cardiovascular risk factors.MethodsThis is a prospective cohort study using data from Waves I and III of the National Longitudinal Study of Adolescent Health (Add Health) (N = 14,322). We tested whether Wave I tobacco use, physical activity/inactivity, and BMI predicted self-report of being diagnosed with high blood pressure (BP) or high cholesterol by Wave III, while controlling for gender, age, race/ethnicity, use of healthcare, and Wave III tobacco use, physical activity/inactivity, BMI.ResultsAmong young adults aged 18–26, 5.37% report high BP and 4.28% high cholesterol. Obese adolescents are more likely to report high BP by young adulthood than normal-weight adolescents, independent of all control variables including BMI in young adulthood (adjusted odds ratio [aOR] = 1.96; 95% confidence interval = [1.50–2.57]). Overweight and obese adolescents are more likely to report high cholesterol by young adulthood than normal-weight adolescents, independent of all control variables including BMI in young adulthood (aOR = 1.47 [1.14–1.90] and 2.05 [1.44–2.91], respectively). Adolescent tobacco use and physical activity/inactivity do not independently predict reported high BP or cholesterol.ConclusionsThe odds of overweight and obese adolescents reporting a diagnosis for two cardiovascular risk factors by young adulthood are 1.5 to two times higher than normal-weight adolescents, regardless of BMI in young adulthood. The impact of transient and sustained increases in adolescent BMI on the evolution of cardiovascular risk warrants further investigation.