Background
Elevated blood pressure (BP) levels in childhood have been associated with subsequent atherosclerosis. However, it is uncertain whether this risk is attenuated in individuals who acquire normal BP by adulthood. The present study examined the effect of child and adult BP levels on carotid artery intima-media thickness (cIMT) in adulthood.
Methods and Results
The cohort consisted of 4,210 participants from four prospective studies (mean follow-up 23 years). Childhood elevated BP was defined according to the tables from the National High Blood Pressure Education Program. In adulthood BP was classified as elevated for individuals with systolic BP ≥120mmHg, diastolic BP ≥80mmHg or with self-reported use of antihypertensive medications. cIMT was measured in the left common carotid artery. High IMT was defined as an IMT ≥age-, sex-, race-, and cohort-specific 90th percentile. Individuals with persistently elevated BP and individuals with normal childhood BP, but elevated adult BP had increased risk of high cIMT (RR[95%CI]) 1.82[1.47-2.38] and 1.57[1.22-2.02], respectively) when compared to individuals with normal child and adult BP. In contrast, individuals with elevated BP as children but not as adults did not have significantly increased risk (1.24[0.92-1.67]). In addition, these individuals had lower risk of increased cIMT (0.66[0.50-0.88]) when compared to those with persistently elevated BP. The results were consistent when controlling for age, sex, adiposity and when different BP definitions were applied.
Conclusions
Individuals with persistently elevated BP from childhood to adulthood had increased risk of carotid atherosclerosis. This risk was reduced if elevated BP during childhood resolved by adulthood.
Childhood BMI, CRP, family income (inversely), mother's BMI, and polymorphisms near genes FLJ35779, TFAP2B, and LRRN6C are independently related to adulthood obesity. However, because genetic risk markers and CRP only marginally improve the prediction, our results indicate that children at high risk of adult obesity can be identified using a simple non-laboratory-based risk assessment.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.