Abstract 18030: Modifiable Factors Affect the Trajectory of Blood Pressure from Childhood to Adulthood: Opportunities for Early Intervention
Background: Elevated blood pressure (BP) in childhood is associated with elevated BP, including hypertension, in adulthood. However, the modifiable factors that alter the trajectory of BP tracking from childhood to adulthood, and which might provide opportunities for reducing long-term cardiovascular disease risk, are poorly characterized.
Aim: To determine the modifiable factors associated with the resolution of elevated BP by early adulthood.
Method: Data from 798 participants in the Childhood Determinants of Adult Health Study (53% female) had baseline measurements collected in 1985 when aged 9-, 12-, and 15-years and were followed-up 20-years later. BP was classified according to the NHBPEP guidelines in childhood and JNC8 guidelines in adulthood. Modifiable factors available at both examinations included body mass index (BMI), fruit and vegetable intake, physical activity, cardiorespiratory fitness, smoking and socioeconomic position (SEP). BP trajectory groups (persistent normal, resolution, incident, persistent elevated) were established according to elevated BP status (prehypertensive or hypertensive) in childhood and adulthood.
Results: Spearman’s correlation coefficients for BP tracking from childhood to adulthood was 0.31 (P<0.001) for systolic BP and 0.16 (P<0.001) for diastolic BP. Children with elevated BP had a 35% increased risk of elevated BP in adulthood compared with those with normal BP (relative risk=1.35, 95%CI=1.18-1.55, P<0.001). Relative to those with persistently elevated BP, participants in the resolution group (n=118) significantly decreased their BMI z-score and increased their vegetable consumption z-score in the time between childhood and adulthood. Moreover, the proportion of participants with upwardly mobile SEP was significantly higher in the resolution group (41.6%) than the persistent elevated group (27.5%). In females, current hormonal contraceptive use was lower in the resolution group (29.5%) compared with the incident (46.7%) and persistent elevated (42.9%) groups.
Conclusions: Resolution of elevated BP in the transition from childhood to adulthood appeared to be partially determined by modifiable factors associated with a healthy lifestyle.
Author Disclosures: R. Kelly: None. R. Thomson: None. K. Smith: None. T. Dwyer: None. A. Venn: None. C. Magnussen: None.
- © 2014 by American Heart Association, Inc.