Urbina EM, et al. - Among 303 adolescents (mean age 15.6 years, 63% white, 55% male), researchers assessed the link of systolic blood pressure (SBP) percentile, independent of obesity, on left ventricular mass index (LVMI). In addition, the SBP percentile that can best predict left ventricular hypertrophy (LVH) in youth was estimated. Participants were grouped by SBP as low-risk (L=141, <80th percentile), mid-risk (M=71, 80–<90th percentile), or high-risk (H=91, ≥90th percentile). While there was a slight difference by body mass index, there were no differences in age or demographics across BP groups. Across groups, a rise in mean BP, LVMI, and prevalence of LVH was noted. After adjusting for covariates, SBP percentile continued to significantly determine LVMI. For predicting LVH (LVMI≥38.6 g/m^2.7), the best balance between sensitivity and specificity was provided by the 90th percentile for SBP. At BP levels below those used to define hypertension, abnormalities in cardiac structure could be detected in youth.