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Observational Study
. 2018 Jul;72(1):93-101.
doi: 10.1161/HYPERTENSIONAHA.118.10975. Epub 2018 May 21.

Trajectories of Childhood Blood Pressure and Adult Left Ventricular Hypertrophy: The Bogalusa Heart Study

Tao Zhang  1   2 , Shengxu Li  2 , Lydia Bazzano  2 , Jiang He  2 , Paul Whelton  2 , Wei Chen  3
Affiliations
Observational Study

Trajectories of Childhood Blood Pressure and Adult Left Ventricular Hypertrophy: The Bogalusa Heart Study

Tao Zhang et al. Hypertension. 2018 Jul.

Abstract

This longitudinal study aims to characterize longitudinal blood pressure (BP) trajectories from childhood and examine the impact of level-independent childhood BP trajectories on adult left ventricular hypertrophy (LVH) and remodeling patterns. The longitudinal cohort consisted of 1154 adults (787 whites and 367 blacks) who had repeated measurements of BP 4 to 15 times from childhood (4-19 years) to adulthood (20-51 years) and assessment of echocardiographic LV dimensions in adulthood. Model-estimated levels and linear slopes of BP at childhood age points were calculated in 1-year intervals using the growth curve parameters and their first derivatives, respectively. Linear and nonlinear curve parameters of BP showed significant race and sex differences from age 15 years onwards. Adults with LVH had higher long-term BP levels than adults with normal LVM in race-sex groups. Linear and nonlinear slope parameters of BP differed consistently and significantly between LVH and normal groups. Associations of level-independent linear slopes of systolic BP with adult LVH were significantly inverse (odds ratio=0.75-0.82; P=0.001-0.015) in preadolescent children of 4 to 9 years but significantly positive (odds ratio=1.29-1.46; P=0.001-0.008) in adolescents of 13 to 19 years, adjusting for covariates. These associations were consistent across race-sex groups. Of note, the association of childhood BP linear slopes with concentric LVH was significantly stronger than that with eccentric LVH during the adolescence period of 12 to 19 years. These observations indicate that the impact of BP trajectories on adult LVH and geometric patterns originates in childhood. Adolescence is a crucial period for the development of LVH in later life, which has implications for early prevention.

Keywords: adolescent; blood pressure; echocardiography; hypertrophy, left ventricular; longitudinal studies.

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Conflict of interest statement

The authors do not have any conflict of interest.

Figures

Figure 1
Figure 1. Growth curves of blood pressure by race-sex group
Curve parameters were all different from 0 (p<0.001) except −0.05 (p=0.023) and 0.0001 (p=0.965) for DBP in black males (see detailed information on the curve parameters in Supplemental Table S1).
Figure 2
Figure 2
Growth curves of systolic blood pressure in adults with and without LVH by race and sex
Figure 3
Figure 3
Odds ratio (OR) and 95% confidence interval (CI) of model-estimated levels and level-adjusted linear slopes of SBP for adult LVH by childhood age, adjusting for adult age, race, sex, adult SBP, adult smoking and alcohol use, and childhood BMI levels
Figure 4
Figure 4
Odds ratio (OR) and 95% confidence interval (CI) of model-estimated, level-adjusted linear slopes of SBP for adult eccentric and concentric LVH by childhood age, adjusting for adult age, race, sex, adult SBP, adult smoking and alcohol use, and childhood BMI levels
See this image and copyright information in PMC

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