Blood Pressure Trajectories from Childhood to Adolescence in Pediatric Hypertension

Abstract

It has been known for a long time that elevated blood pressure (BP) in the young may persist and progress into adult hypertension (HTN). Multiple studies have revealed the predicted BP trajectory lines starting from childhood and related them to later cardiovascular (CV) risks in adulthood. As a small baby grows into a tall adult, BP will also naturally increase. Among early-life predictors of adult HTN, birth history, such as prematurity, and low birth weight have been popular subjects in research on pediatric HTN, because body size at birth has been reported to be inversely related to the risk of adulthood HTN. The hypothesis of HTN in prematurely born adolescents has been postulated as a physiological predisposition to postnatal excessive weight gain. Current body weight is a well-known independent predictor of HTN in children, and some studies showed that children demonstrating upward crossing of their weight percentiles while growing into adolescents have significantly increased risk for elevated BP later in life. Recently, reports focused on the adverse effect of excessive catch-up growth in this population are gradually drawing attention. Accordingly, children born prematurely or with intrauterine growth restriction who show rapid changes in their weight percentile should be under surveillance with BP monitoring. Prevention of childhood obesity, along with special care for premature infants or infants small for their gestational age, by providing healthy nutritional guidelines should be cardinal strategies for the prevention of adult HTN and CV risks later in life.

Clinical follow-up study of 166 cases of children with hypertension

“…Our 10-year retrospective study found 91 cases of primary hypertension versus 75 cases of secondary hypertension, consistent with the American Academy of Pediatrics findings. With the increasing rate of obesity in children, primary hypertension has become one of the most common diseases in children (8,9). In our study, hypertension more commonly affected male patients than female patients, regardless of whether it was primary or secondary hypertension, showing significant differences between sex.…”

Prevalence trends of hypertension among 9–17 aged children and adolescents in Yunnan, 2017–2019: a serial cross-sectional surveillance survey

“…Previous studies confirmed that childhood hypertension not only affected children’s health, but also had a “trajectory” of blood pressure. In other words, childhood hypertension can gradually develop into adult hypertension and increase the risk of cardiovascular disease in adulthood [ 7 , 10 , 15 , 24 , 36 , 37 ]. Thus, we should pay more attention on the prevention and control of children and adolescents’ hypertension.…”

“…The prevalence of hypertension in Chinese children and adolescents has increased from 7.1% in 1991 to 13.8% in 2009, with an average annual rate of 0.47% [8,9]. And more and more studies have found that the origin of hypertension in adulthood could be traced back to hypertension in childhood [7,[10][11][12][13]. Children with elevated blood pressure were more likely to become hypertensive adults [14,15].…”

“…Hypertension was once rare in children and adolescents. But it has raised a serious public health challenge to us [ 6 , 7 ]. The prevalence of hypertension in Chinese children and adolescents has increased from 7.1% in 1991 to 13.8% in 2009, with an average annual rate of 0.47% [ 8 , 9 ].…”

Obesity-associated Hypertension among Primary School Children in Sarawak: A Cross-sectional Study

“…showed that initial childhood blood pressure level was one of the strong predictors of adult blood pressure (Klumbiene et al 2000;Oh & Hong, 2019). Hypertension is not uncommon among children.…”