Blood pressure in children and target-organ damage later in life

Abstract

The aim of this study was to examine the association between blood pressure (BP) in children and adolescents and cardiovascular and renal disease in adulthood. This was a retrospective study on patients <18 years of age with an elective admission to Landspitali University Hospital in Reykjavik, Iceland, between 1950 and 1967. We recorded baseline variables including BP and invited all patients for a follow-up visit in 2008 for repeat studies. We used chi(2), Fisher's exact test, and logistic regression to examine the association between BP in childhood and outcome variables at follow-up. We identified 126 individuals (54 men) for the study. The median age (range) at childhood admission was 15 (10-17) years and the median BP was 125/80 mmHg. Median age at follow-up was 58 (42-68) years, follow-up time 43 (25-52) years, and median BP 133/75 mmHg. Eleven had died (five men) and 49 had been diagnosed with hypertension (23 men) and 12 with coronary artery disease (ten men). There was a significant correlation between the diagnosis of coronary artery disease at follow-up and childhood systolic BP (odds ratio = 1.052; P = 0.03) as well as systolic BP >/= 95th percentile (P = 0.03). Our results suggest that elevated childhood systolic BP may increase the risk of coronary artery disease in adult life. The sample size is a limiting factor, and the study should be carried out in a larger population.

Prevalence of Hypertension and Pre-hypertension in 13-17 Year Old Adolescents Living in Mthatha - South Africa: a Cross-Sectional Study

“…The effects of increased BMI on blood pressure were noted in both females and males indicating that beside the protective effects of estrogen in female adolescents, overweight/obesity tended to favour higher blood pressures. Our results confirm the findings of Erlingsdottir et al (27), who showed an association between overweight/obesity and higher blood pressure. The mechanism whereby overweight/obesity may lead to higher blood pressure seems to be due to enhanced adipocyte secretion of adipokines and pro-inflammatory cytokines which may disrupt normal physiological function leading to increased blood pressure (27).…”

2016 European Society of Hypertension guidelines for the management of high blood pressure in children and adolescents

“…After 17 years of follow-up, BP values in young individuals show a significant association with cardiometabolic risk (14), and may also predict coronary artery disease in adult life (15). …”

“…Before considering antihypertensive agents a re-coarctation must be ruled out. In children aged [7][8][9][10][11][12][13][14][15][16] years the prevalence of restenosis is suggested to be as high as 21% (276) and masked HTN is common, then ABPM should be performed regularly from the age of seven (80). Exercise HTN may also be present despite the lack of early or long-term residual or recurrent obstruction.…”

Blood Pressure in Schoolchildren and Adolescents and its Variation according to Nutritional Status Evaluation: An Early Preventive Key for Obesity Comorbidities

“…To the well-known silent cardiovascular alterations in pediatric ages [3], it is important to consider the Iceland-study [8] on target-organ damage when estimated at a mean of 58 years of age. There is a significant correlation between both coronary disease and adult hypertension with adolescents' blood pressures ≥ 95 th centile.…”