摘要Background The impact of pediatric body mass index(BMI)trajectories on the risk of adolescent hypertension(HTN)determined by three separate visits remains unclear.This longitudinal study aims to identify potential pediatric sex-specific BMI trajectories and to assess their associations with HTN and HTN subtypes.Methods Based on the Health Promotion Program for Children and Adolescents(HPPCA)in Suzhou,China,a total of 24,426 participants who had initial normal blood pressure(BP)and had at least four BMI measurements during 2012-2020 were included.HTN was defined as simultaneously having three separate visits of elevated BP in 2020.Latent class growth models were used to explore sex-specific BMI trajectories,whose associations with HTN and HTN subtypes were further examined by logistic regression.Results The incidence of HTN determined through three separate visits was 3.34％.Four trajectories were identified for both sexes:low BMI increasing,medium BMI increasing,high BMI increasing,and highest BMI increasing.Compared to the medium BMI increasing group,the odds ratio(95％confidential interval)for developing adolescent HTN of the low,high,and highest BMI increasing groups among boys were 0.54(0.39,0.75),1.90(1.44,2.51),and 2.89(1.90,4.39),respectively;and the corresponding values for girls were 0.66(0.48,0.90),2.30(1.72,3.09),and 4.71(3.06,7.26).Similar gradually elevated associations between different trajectories with isolated systolic hypertension,systolic and diastolic hypertension were observed.Conclusion Current results emphasized the adverse effects of stable high BMI on HTN and the benefits of maintaining normal weight throughout childhood.