Sex Differences in Blood Pressure Trajectories Among Adolescents Attending Secondary School in Urban Tanzania

High blood pressure (BP) among adolescents is a growing public health problem known to persist into adulthood. However, there is a scarcity of longitudinal BP data in Sub‐Saharan Africa (SSA). We aimed to describe sex differences in BP trajectories and determine the incidence of high BP among 500 secondary school−attending adolescents enrolled in a 2‐year closed cohort study in urban Tanzania. We collected data across three time points, spaced at 12‐month intervals. Participants were defined as having high BP if they had elevated BP or hypertension as per the standard guideline. Overall, there was a significant decline in BP from enrollment to Year 1, possibly attributable to the white coat effect. Between Year 1 and Year 2, we found a steeper longitudinal BP increase, particularly in males. The incidence of high BP was 5.5 cases per 100 person‐years and was significantly higher in males and among underweight participants. We recommend integrating routine BP measurement in the existing adolescent health programs and tailoring cardiovascular preventive messages to address gender‐specific risk factors.