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. 2015 Dec;66(6):1108-15.
doi: 10.1161/HYPERTENSIONAHA.115.05831. Epub 2015 Oct 5.

Childhood to Early-Midlife Systolic Blood Pressure Trajectories: Early-Life Predictors, Effect Modifiers, and Adult Cardiovascular Outcomes

Reremoana F Theodore  1 , Jonathan Broadbent  2 , Daniel Nagin  2 , Antony Ambler  2 , Sean Hogan  2 , Sandhya Ramrakha  2 , Wayne Cutfield  2 , Michael J A Williams  2 , HonaLee Harrington  2 , Terrie E Moffitt  2 , Avshalom Caspi  2 , Barry Milne  2 , Richie Poulton  2
Affiliations

Childhood to Early-Midlife Systolic Blood Pressure Trajectories: Early-Life Predictors, Effect Modifiers, and Adult Cardiovascular Outcomes

Reremoana F Theodore et al. Hypertension. 2015 Dec.

Abstract

Previous studies examining blood pressure change over time have modeled an average population trajectory. Recent research among older adults suggests there may be subgroups with different blood pressure trajectories. Identifying subgroups at risk of developing adult hypertension early in life can inform effective risk reduction efforts. We sought to identify different systolic blood pressure trajectories from childhood, their correlated risk factors, and early-midlife cardiovascular outcomes. Blood pressure data at ages 7, 11, 18, 26, 32, and 38 years from a longitudinal, representative birth cohort study (n=975) were used to identify 4 distinct trajectory groups via group-based trajectory modeling: normal (21.8%), high-normal (43.3%), prehypertensive (31.6%), and hypertensive (4.2%). The categories refer to blood pressure beginning at the age of 7 years and most recently measured at the age of 38 years. Family history of high blood pressure (odds ratio [OR], 43.23; 95% confidence interval [CI], 5.27-354.65), male sex (OR, 109.48; 95% CI, 26.82-446.96), being first born (OR, 2.5; 95% CI, 1.00-8.69) and low birth weight (OR, 2.79; 95% CI, 2.49-3.09) were associated with hypertensive group membership (compared with the normal group). Higher body mass index and cigarette smoking resulted in increasing blood pressure across trajectories, particularly for the higher blood pressure groups. Prehypertensive and hypertensive trajectory groups had worse cardiovascular outcomes by early midlife. Harmful blood pressure trajectories are identifiable in childhood, associated with both antecedent and modifiable risk factors over time, and predict adult cardiovascular disease risk. Early detection and subsequent targeted prevention and intervention may reduce the lifecourse burden associated with higher blood pressure.

Keywords: blood pressure; follow-up studies; hypertension; pediatrics; risk factor.

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Figures

Figure 1
Figure 1
Plot of predicted trajectory lines with 95% confidence intervals for the four blood pressure trajectory groups identified in a general population longitudinal birth cohort
See this image and copyright information in PMC

References

    1. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jr, Jones DW, Materson BJ, Oparil S, Wright JT, Jr, Roccella EJ Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, National Heart Lung, and Blood Institute, National High Blood Pressure Education Program Coordinating Committee. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003;42:1206–1252. - PubMed
    1. Expert Panel of Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents. Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescence: Summary report. Pediatrics. 2011;128:S213–256. - PMC - PubMed
    1. Pickering TG, Hall JE, Appel LJ, Falkner BE, Graves JW, Hill MN, Jones DH, Kurtz T, Sheps SG, Roccella EJ Council on High Blood Pressure Research Professional and Public Education Subcommittee American Heart Association. . Recommendations for blood pressure measurement in humans: An AHA scientific statement from the Council on High Blood Pressure Research Professional and Public Education Subcommittee. Journal of Clinical Hypertension. 2005;7:102–109. - PMC - PubMed
    1. Moyer VA on behalf of the U. S. Preventive Services Task Force. Screening for primary hypertension in children and adolescents: U.S. Preventive Services Task Force recommendation statement. Annals of Internal Medicine. 2013;159:613–619. - PubMed
    1. Wills AK, Lawlor DA, Muniz-Terrara G, Matthews F, Cooper R, Ghosh AK, Kuh D, Hardy R. Population heterogeneity in trajectories of midlife blood pressure. Epidemiology. 2012;23:203–211. - PMC - PubMed

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