Repeated Blood Pressure Measurements in Childhood in Prediction of Hypertension in Adulthood. Issue 1 (January 2016)

• Record Type: Journal Article
• Authors: Oikonen, Mervi; Nuotio, Joel; Magnussen, Costan G.; Viikari, Jorma S.A.; Taittonen, Leena; Laitinen, Tomi; Hutri-Kähönen, Nina; Jokinen, Eero; Jula, Antti; Cheung, Michael; Sabin, Matthew A.; Daniels, Stephen R.; Raitakari, Olli T.; Juonala, Markus
• Is Part Of: Hypertension. Volume 67:Issue 1(2016:Jan.)
• Publication Date: 2016-01
• Subjects: atherosclerosis -- blood pressure -- follow-up studies -- hypertension -- risk factors; Hypertension -- Periodicals; Hypertension -- Treatment -- Periodicals; 616.132005
• DOI: 10.1161/HYPERTENSIONAHA.115.06395
• Languages: English
• ISSNs: 0194-911X

Abstract

Abstract : Hypertension may be predicted from childhood risk factors. Repeated observations of abnormal blood pressure in childhood may enhance prediction of hypertension and subclinical atherosclerosis in adulthood compared with a single observation. Participants (1927, 54% women) from the Cardiovascular Risk in Young Finns Study had systolic and diastolic blood pressure measurements performed when aged 3 to 24 years. Childhood/youth abnormal blood pressure was defined as above 90th or 95th percentile. After a 21- to 31-year follow-up, at the age of 30 to 45 years, hypertension (>140/90 mm Hg or antihypertensive medication) prevalence was found to be 19%. Carotid intima-media thickness was examined, and high-risk intima-media was defined as intima-media thickness >90th percentile or carotid plaques. Prediction of adulthood hypertension and high-risk intima-media was compared between one observation of abnormal blood pressure in childhood/youth and multiple observations by improved Pearson correlation coefficients and area under the receiver operating curve. When compared with a single measurement, 2 childhood/youth observations improved the correlation for adult systolic (r=0.44 versus 0.35, P <0.001) and diastolic (r=0.35 versus 0.17, P <0.001) blood pressure. In addition, 2 abnormal childhood/youth blood pressure observations increased the prediction of hypertension in adulthood (0.63 for 2 versus 0.60 for 1 observation, P =0.003). When compared with 2 measurements, third observation did not provide any significant improvement for correlation or prediction ( P always >0.05). A higher number of childhood/youth observations of abnormal blood pressure did not enhance prediction of adult high-risk intima-media thickness. Compared with a single measurement, the prediction of adult hypertension was enhanced by 2 observations of abnormal blood pressure in childhood/youth. Abstract : Supplemental Digital Content is available in the text.