Blood pressure trajectory modeling in childhood: birth-cohort study

Lee, Jung Won; Kim, Nameun; Park, Bohyun; Park, Hyesook; Kim, Hae Soon

doi:10.1186/s40885-019-0133-9

“…Regarding the persistence of cMetS, several studies evaluated the correlation coefficient 30 , 31 , but no study has tried to identify trajectory patterns of cMetS using long-term follow-up data. In a previous study using the same data source, the trajectory of BP, a component of MetS, was analyzed using data from 65 subjects repeatedly measured from 3 to 10 years of age, and the results were similar to the results of this study 32 . The identified trajectory patterns showed that cMetS values were clearly distinguished by trajectory groups from the early period of life and remained stable during a long follow-up period from 3 to 12 years of age.…”

Section: Discussionsupporting

confidence: 69%

Trajectory patterns for continuous metabolic syndrome score in childhood and the cardiovascular risk in adolescence

Choi

¹

,

Lee

²

,

Park

³

et al. 2021

Sci Rep

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We explored the association between the trajectory of the continuous metabolic syndrome score (cMetS) in childhood with high-sensitivity C-reactive protein (hs-CRP) and carotid intima-media thickness (CIMT), which are known to increase cardiovascular disease risk in adolescence. The trajectory of cMetS in childhood (from 3 to 12 years of age) was identified in 833 children who participated in the Ewha Birth and Growth Study. The associations between cMetS and hs-CRP and CIMT were analyzed in 204 out of 833 children who participated in the follow-up at 13–15 years of age and measured hs-CRP and CIMT. Among the 833 children, three groups were classified: cMetS maintained at a low level (n = 198, 23.77%), middle level (n = 530, 63.63%), and at high levels (n = 105, 12.61%). The group with a stable-high cMetS trajectory showed significantly higher hs-CRP levels, and the statistical significance was maintained after adjusting for covariates. This study found that a consistently high cMetS in childhood was significantly associated with higher hs-CRP levels in adolescents, suggesting that it is necessary to intervene in metabolic risk factors early in life to reduce the risk of cardiovascular disease later in life.

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“…LVH and LAE are an important cardiac component of HMOD, and HMOD is associated with an increased risk of cardiovascular disease in patients with hypertension [ 19 ]. Because LVH comes from a maladaptive response to chronic overload of LV afterload, the antihypertensive medications which reduce LV afterload can reverse LVH [ 20 ]. Thus, identifying high-risk subjects developing HMOD can give us a chance to prevent future cardiovascular events.…”

Section: Discussionmentioning

confidence: 99%

“…However, current risk prediction models include BP levels only at one time of the risk prediction and neglect the effect of BP levels over time [ 7 ]. The BP trajectory model can describe the course of BP variables over time [ 20 ]. Also, SBP increases with aging, and the patterns of BP change with aging may differ among individuals [ 21 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

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Blood Pressure Trajectories for 16 Years and the Development of Left Ventricular Hypertrophy and Increased Left Atrial Size: The Korean Genome and Epidemiology Study

Kim

¹

,

Lee

²

,

Lee

³

et al. 2022

International Journal of Hypertension

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Background. Elevated single blood pressure (BP) measurement can be associated with the development of hypertension-mediated target organ damage including left ventricular hypertrophy (LVH) and left atrial (LA) enlargement (LAE). However, long-term patterns of BP and their effects on LVH and LAE are poorly understood. We evaluated the association between the BP trajectories and the presence of LVH and LAE. Methods. We analyzed a total of 2,565 participants (1,267 males, 47.8 ± 6.7 years old) from the first biennial examination (2001-2002) of the Korean Genome and Epidemiology Study. The presence of LVH and LAE was identified by echocardiography performed at the 8th biennial examination (2015-2016). Latent mixture modeling was used to identify trajectories in mid-BP ((systolic BP + diastolic BP)/2) over time. Linear logistic regression was used for assessing BP trajectories with the outcomes. Results. We identified 4 distinct mid-BP trajectories: group 1 (lowest, 20.9%, n = 536), group 2 (36.2%, n = 928), group 3 (32.3%, n = 828), and group 4 (highest, 10.6%, n = 273). Compared with the lowest group, trajectories with elevated mid-BP had greater odds ratios having LVH and LAE by multivariable-adjusted regression models. Adjusted odd ratios for LVH were 2.033 (95% CI = 1.462–2.827, P < 0.001 ) for group 2, 3.446 (95% CI = 2.475–4.797, P < 0.001 ) for group 3, and 4.940 (95% CI = 3.318–7.356, P < 0.001 ) for group 4. Adjusted odd ratios for LAE were 1.200 (95% CI = 0.814–1.769, P = 0.358 ) for group 2, 1.599 (95% CI = 1.084–2.360, P = 0.018 ) for group 3, and 1.944 (95% CI = 1.212–3.118, P = 0.006 ) for group 4. Conclusions. Higher long-term mid-BP was an independent risk factor of cardiac structural changes such as LVH and LAE among middle-aged population.

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“…Consequently, NCDs and primarily cardiovascular diseases have taken over as the chief cause of morbidity and mortality, accounting for 71% of annual deaths globally [ 1 ]. Accumulating evidence is shedding light on the tracks of NCDs and specifically cardiovascular diseases in the preadulthood, highlighting the significance of early environmental exposures [ 2 – 8 ]. Accordingly, childhood and adolescence could be considered opportunities to prevent NCDs from happening later in life through environmental and behavioral interventions.…”

Section: Introductionmentioning

confidence: 99%

Subjective Proximity to Green Spaces and Blood Pressure in Children and Adolescents: The CASPIAN-V Study

Abbasi

¹

,

Pourmirzaei

²

,

Hariri

³

et al. 2020

Journal of Environmental and Public Health

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Evidence favoring a beneficial association between greenness and blood pressure (BP) in adults is accumulating. However, children and adolescents have been understudied accordingly. Methodologically, the data on “exposure” to residential green spaces are commonly satellite-derived, including rare existing studies on the relationship between proximity to green spaces and BP in children. Despite perfectly obliterating subjective biases, remote sensing methods of greenness data collection fail to address pragmatic interaction with such settings. This study aimed to assess the relationship between subjective proximity to green spaces and average/elevated BP in children. Through our study, systolic and diastolic BPs of 12,340 schoolchildren living in CASPIAN-V study areas were examined and recorded. We performed surveys to obtain the data on their proximity to green spaces, defined as having access to such spaces within a 15-minute walk from their homes. Linear mixed-effects models with BP as the outcome variable and the measure of exposure to green spaces as fixed-effect predictor were applied. The analysis was adjusted for several covariates. We found that perceived residential proximity to green spaces was associated with −0.08 mmHg (95% confidence intervals (CIs): −0.58, 0.41; p value = 0.72) reduction in systolic BP and −0.09 (95% CIs: −0.49, 0.31; p value = 0.66) reduction in diastolic BP. We also observed statistically nonsignificant odds ratio of 1.03 (95% CIs: 0.76, 1.39), 0.96 (95% CIs: 0.80, 1.16), and 0.98 (95% CIs: 0.82, 1.16) for isolated systolic/diastolic hypertension and hypertension, respectively. Our observations remained consistent after adjustment for height, parental employment, low birth weight, parental obesity, single parent, and breastfeeding. In conclusion, subjective proximity to green spaces might not be associated with a lower mean BP in children. Well-designed studies applying both subjective and objective data should be performed to elaborate on the relationship further.

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Blood pressure trajectory modeling in childhood: birth-cohort study

Cited by 7 publications

References 23 publications

Trajectory patterns for continuous metabolic syndrome score in childhood and the cardiovascular risk in adolescence

Trajectory patterns for continuous metabolic syndrome score in childhood and the cardiovascular risk in adolescence

Blood Pressure Trajectories for 16 Years and the Development of Left Ventricular Hypertrophy and Increased Left Atrial Size: The Korean Genome and Epidemiology Study

Subjective Proximity to Green Spaces and Blood Pressure in Children and Adolescents: The CASPIAN-V Study

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