High blood pressure in childhood can predict hypertension and cardiovascular disease in adulthood

John Murphy, MDLinx | October 13, 2015

Risks of high blood pressure in adulthood—and consequent cardiovascular disease—can be predicted in childhood, according to a longitudinal study published online October 5, 2015 in Hypertension. Early detection of these risks would allow for targeted prevention and intervention efforts, and reduce the lifelong burden of hypertension, the authors suggested.

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Child blood pressure linked to adult cardiovascular disease

Long before systolic blood pressure rises to detectable levels of prehypertension or hypertension in adulthood, elevated blood pressure can be screened in childhood. (Photo: Amanda Mills/CDC)

The researchers followed participants in the Dunedin Multidisciplinary Health and Development Study, which has tracked 1,037 individuals born in 1972 to 1973 in Dunedin, New Zealand. Subjects’ blood pressure was measured periodically from ages 7 to 38. From these data, researchers identified 4 distinct blood pressure trajectory groups:

  • Normal (21.8%)
  • High-normal (43.3%)

  • Prehypertensive (31.6%)
  • Hypertensive (4.2%)

Prehypertensive and hypertensive trajectory groups had worse cardiovascular outcomes by early midlife, the researchers found.

“The findings from this study suggest that groups of individuals who will develop high systolic blood pressure in early to mid-adulthood have elevated blood pressure in childhood, and that these individuals are more likely to be affected by cardiovascular disease–related comorbidity by age 38 years,” the authors wrote.

Lead author and research fellow Reremoana Theodore, PhD, and colleagues in the Department of Psychology at the University of Otago, in Dunedin, NZ, also identified a number of factors in early life that increased the odds of being in a high-risk blood pressure group.

“These included being male, having a family history of high blood pressure, being first born, and being born lower birthweight,” she said. “This new information is useful for screening purposes to help clinicians identify young people who may develop high blood pressure later in adulthood.”

Results also showed that a higher body mass index and cigarette smoking were associated with increasing blood pressure levels over time, especially for those in the higher blood pressure groups.

The authors concluded that “estimating risk for future hypertension (and cardiovascular disease more generally) can be undertaken among children, long before systolic blood pressure rises to clinically detectable levels of prehypertension or hypertension in adulthood.”

They added that “this research reinforces the importance of encouraging lifestyle changes including supporting the maintenance of a healthy body weight, particularly for those already on a high-risk blood pressure trajectory into adulthood.”

“Our findings can be used to inform early detection, targeted prevention, and/or intervention to help reduce the burden associated with this silent killer,” Dr. Theodore said.

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