Pediatric BP in higher percentiles predicts adult hypertension

  • Hypertension

  • International Clinical Digest
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Takeaway

  • Systolic BP ≥70th percentile in childhood predicts adult hypertension.
  • BP increase between ages 10 and 16 years also predicts adult hypertension, even if childhood BP is normal.

Why this matters

  • The authors say that their precision for predicting individual risk is weak but that a steep BP climb in childhood warrants lifestyle intervention.

Key results

  • Correlation for childhood and young adult BP was significant (P<.0001>
  • Hypertension in adulthood was more common in black than white respondents (P<.0001 and in males vs females>
  • Adults reporting hypertension had higher BP, BMI, triglycerides in childhood vs adults not reporting hypertension (P<.02 for all>
  • Childhood systolic BP in ≥90th percentile increased odds for adult hypertension: OR, 2.0 (95% CI, 1.6-2.5).
  • Systolic BP in ≥90th percentile increased odds even more: OR, 3.0 (95% CI, 2.2-4.1; all P<.0001>
  • Even with normotensive measures in childhood, a steep increase signaled higher BP in adulthood.

Study design

  • 5035 participants (mean age, 46.7 years), data from 6 of the 7 studies in the i3C Consortium.
  • BP was tracked in those with childhood and adulthood BP values, with logistic regression for predictive association.
  • Funding: NIH.

Limitations

  • Self-reported hypertension.
  • Data collection before 2017 guidelines change in hypertension cutoffs.

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