The Role of Parent-Adolescent Relationships in the Development of (Pre)Hypertension in Young Adulthood in the U.S.

BACKGROUND: Hypertension is a strong factor for stroke and coronary disease, and it has been found that 1 in 4 young adults are experiencing pre-hypertension in the United States This study was designed to examine the role of parent-adolescent relationships in the risk of developing (pre)hypertension in young adulthood, and to explore potential mediator(s).

METHODS: Our analysis was based on the data from the National Longitudinal Study of Adolescent to Adult Health, Wave 1 (aged 13-18) and Wave 4 (aged 25-32) (N = 3,350). Three parent-adolescent relationships were extracted from a factor analysis, and four different specifications of (pre)hypertension were generated and tested individually. We applied generalised structural equation modelling to perform path analysis estimations.

RESULTS: We found that mother-reported relationship quality had both a direct and an indirect effect via alcohol consumption, on the likelihood of (pre)hypertension in young adulthood. The path from relationship quality to (pre)hypertension via alcohol consumption was consistent with three different specifications of hypertension (pre-hypertension, clinical/experienced hypertension, and experienced hypertension), suggesting the path relation was evident. Our study also showed that both relationship quality and adolescent-reported maternal warmth/responsiveness were associated with the risk of clinical/experienced hypertension via mental health problems. Parental control was found to have a direct and protective effect on clinical/experienced hypertension.

CONCLUSIONS: Early family relationships in adolescence predict (pre)hypertension in young adulthood. Initiatives related to parent-adolescent relationships, and the associated effects on later alcohol consumption and mental health problems, may have a long implication on the risk of (pre)hypertension in adulthood.