**5. Conclusions**

As CVD remains the leading cause of death in adults and the fifth leading cause of death for those aged 15–24 years old, there is a critical need for additional research and interventions to address CVD risk factors, such as high blood pressure [1–3]. In addition, as literature supports that CVD may originate during childhood or adolescence, it is vital to address these risk factors at this critical period [1,5–8]. In this study, working may have increased the risk of high blood pressure in adolescents, specifically those who are in their early high school years. Future studies based on a larger sample of workers are needed to confirm the present study's findings and estimate the association between specific work-related exposures and elevated blood pressure, while accounting for nutritional and other potential risk factors. Future research could also identify the specific mechanism of how work status may increase hypertension in adolescents. The findings from this study provide a motivation for subsequent research in the areas of working youth and high blood pressure.

**Author Contributions:** E.M.S. assisted in design of the original study and served as the project manager. She oversaw data collection and data management for the study and assisted in the data analysis and interpretation of findings. She was responsible for overall manuscript development. S.P.C. was the principal investigator for the study. She was responsible for its design and overall conduct. She assisted in the interpretation of study findings and edited the manuscript. L.J. developed the analysis plan and was responsible for executing the data analysis. A.B.T. assisted in the literature review and overall manuscript development. J.R. assisted in the literature review, development of the manuscript, and final manuscript review.

**Funding:** This paper was supported by CDC/NIOSH under Cooperative Agreement No. U50 OH07541 to the Southwest Center for Agricultural Health, Injury Prevention, and Education at the University of Texas Health Science Center at Tyler. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of CDC/NIOSH.

**Acknowledgments:** We would like to especially thank Yolanda Morado from Texas A&M AgriLife Extension for supporting this project and her dedication toward improving the health of families along the Texas-Mexico border. We would like to thank the students who participated and the school administrators, teachers and staff who made this study possible, specifically Linda Taormina.

**Conflicts of Interest:** None of the authors have a financial or non-financial competing interest with respect to the study and information presented in this manuscript.
