Essential hypertension predicted by tracking of elevated blood pressure from childhood to adulthood: The Bogalusa heart study*

Abstract

It is well known that blood pressure (BP) levels persist over time. The present investigation examines tracking of elevated BP from childhood to adulthood and its progression to essential hypertension. In a community study of early natural history of arteriosclerosis and essential hypertension, a longitudinal cohort was constructed from two cross-sectional surveys > 15 years apart: 1505 individuals (56% female subjects, 35% black), aged 5 to 14 years at initial study. Persistence of BP was shown by significant correlations between childhood and adulthood levels (r = 0.36 to 0.50 for systolic BP and r = 0.20 to 0.42 for diastolic BP), varying by race, sex, and age. These correlations remained the same after controlling for body mass index (BMI). Twice the expected number of subjects (40% for systolic BP and 37% for diastolic BP), whose levels were in the highest quintile at childhood, remained there 15 years later. Furthermore, of the childhood characteristics, baseline BP level was most predictive of the follow-up level, followed by change in BMI. Subsequently, even at ages 20 to 31 years, prevalence of clinically diagnosed hypertension was much higher in subjects whose childhood BP was in the top quintile: 3.6 times (18% v 5%) as high in systolic BP and 2.6 times (15% v 5.8%) as high in diastolic BP, compared to subjects in every other quintile. Of the 116 subjects who developed hypertension, 48% and 41% had elevated childhood systolic and diastolic BP, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Tracking and factors predicting rising in ‘tracking quartile’ in blood pressure from childhood to adulthood: Odense Schoolchild Study

“…2,3,7,9,29 These factors were also found in the final models for the prediction of rising in quartile through this 11-year follow-up. The models in the present study were not designed to predict followup BP but to compare subjects who moved to a higher quartile with subjects who either stayed or declined to a lower quartile.…”

“…The degree of tracking of BP, weight, height and BMI as well as the almost identical tracking correlations in males and females were in general within the same range found in other longitudinal studies concerning tracking from childhood to adulthood. 2,3,5,19,[21][22][23] The minor discrepancy between the studies could be due to differences in measurement procedures, follow-up losses (dropouts) 24 or length of follow-up period. Studies of BP tracking have shown lower correlation coefficients with increasing length of time between examinations.…”

“…However the evidence of significant BP tracking from childhood to adulthood is numerous, but the reported degree of tracking is conflicting. 2,[4][5][6][7][8][9][10][11][12][13] Factors predicting BP in adulthood from childhood variables have been investigated, 2,3,8,14 and childhood BP, change in relative weight as well as BP response to an exercise test performed in childhood are the most convincing factors. In addition studies have shown that children who have a fall or a rise in BP in relation to their peers have a relative body growth similar to those who maintained their rank order as low or high respectively.…”

The trend of hypertension and its relationship to the weight status among Taiwanese young adolescents

“…Elevated blood pressure levels in children strongly indicate that they will suffer from hypertension as adults. 4,5 Studies also demonstrate that the prevalence of hypertension among US children increased from 2.1 to 3.0% between 1988 and 2006 (McCrindle 6 ; Ostchega et al 7 ) and 16.1-22.9% between 2004 and 2007 in Greece. 8 Pre-hypertension is a high risk for developing hypertension, which may also lead to coronary heart disease.…”

“…13,14 The growing obesity epidemic may contribute to an unexpected increase in the number of children with hypertension. 15,16 Since childhood hypertension is associated with adulthood hypertension and other chronic diseases, 4 previous studies advocate the early detection and prevention of childhood hypertension. 11,15,[17][18][19] In Taiwan, the increasing availability of high fat, high calorie foods has contributed to the continually increasing obesity levels of adults and children.…”