Determinants of Blood Pressure in Preschool Children

Abstract

Background-Hypertension is the leading risk factor for cardiovascular disease. Although accumulating evidence suggests tracking of blood pressure from childhood into adult life, there is little information regarding the relative contributions of genetic, prenatal, biological, behavioral, environmental, and social determinants to childhood blood pressure. Methods and Results-Blood pressure and an array of potential anthropometric, prenatal, environmental, and familial risk factors for high blood pressure, including parental smoking habits, were determined as part of a screening project in 4236 preschool children (age 5.7Ϯ0.4 years). Smoking was reported by 28.5% of fathers and 20.7% of mothers, and by both parents 11.9%. In addition to classic risk factors such as body mass index, prematurity, low birth weight, and parental hypertension, both systolic (ϩ1.0 [95% confidence interval, ϩ0.5 to ϩ1.5] mm Hg; Pϭ0.0001) and diastolic blood pressure (ϩ0.5 [ϩ0.03 to ϩ0.9] mm Hg; Pϭ0.03) were higher in children of smoking parents. Parental smoking independently affected systolic blood pressure (Pϭ0.001) even after correction for other risk factors, such as body mass index, parental hypertension, or birth weight, increasing the likelihood of having a systolic blood pressure in the top 15% of the population by 21% (2% to 44%; Pϭ0.02). Conclusions-In healthy preschool children, parental smoking is an independent risk factor for higher blood pressure, adding to other familial and environmental risk factors. Implementing smoke-free environments at home and in public places may provide a long-term cardiovascular benefit even to young children. (Circulation. 2011;123:292-298.)

Relationships Between Physical Activity and Health Measures in Preschool Children

“…Nevertheless, our prevalence of prehypertension/hypertension was lower than the 14% observed in a large Australian cohort (~2000 preschoolers) (Gopinath et al, 2011a). In agreement with recent literature in preschoolers, we observed a trend for higher SBP %ile in girls compared to boys (Simonetti et al, 2011).…”

“…While older studies have observed an inverse relationship between BP and aerobic fitness in preschoolers (Gutin et al, 1990;Shea et al, 1994), it is not known how PA relates to BP in this young age group. PA may indirectly affect BP through energy balance and body composition, as preschoolers with higher BMIs have elevated SBP and DBP (Simonetti et al, 2011;Gopinath et al, 2011a). For the first time, this thesis will characterize the relationship between BP and PA in preschoolers.…”

“…There are important relationships between these health measures in preschoolers that have yet to be discussed and have not been included in Figure 2. Less favorable body composition, for example, is associated with elevated SBP and DBP in preschoolers (Simonetti et al, 2011;Gopinath et al, 2011a). Likewise, DBP is negatively correlated with fitness (Gutin et al, 1990), and preschoolers in the highest quintile of a submaximal fitness assessment experienced smaller increases in BP over a 20-month follow-up (Shea et al, 1994).…”

Physical Activity, Obesity Status, and Blood Pressure in Preschool Children

“…Comparisons with other studies are difficult due to lack of data in preschool-aged children. Although childhood BP is influenced by genetic and prenatal factors, as well as by dietary habits and environmental factors, such as passive smoking, 28 our results have importance from a primary prevention perspective. First, children who are overweight or obese at an early age have greater odds of having CVD risk factors such as BP [29][30][31][32] as well as an increased risk for developing cardiovascular and metabolic conditions later in life.…”

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

“…The heart and vascular system are highly vulnerable to tobacco smoking. Discouraging maternal smoking and maintaining a strictly smoke-free environment are of great importance due to the accumulating evidence on the importance of fetal and early life factors in determining CV risk (209). In adolescents, promotion of smokefree rules at home may help prevent the uptake of cigarettes.…”