Childhood Physical, Environmental and Genetic Predictors of Adult Hypertension: The Cardiovascular Risk in Young Finns Study
Background—Hypertension is a major modifiable cardiovascular risk factor. The present longitudinal study aimed to examine the best combination of childhood physical and environmental factors to predict adult hypertension and furthermore, whether newly identified genetic variants for blood pressure (BP) increase the prediction of adult hypertension.
Methods and Results—Study cohort included 2,625 individuals from the Cardiovascular Risk in Young Finns Study who were followed up for 21-27 years since baseline (1980, age 3-18 years). In addition to dietary factors and biomarkers related to blood pressure, we examined whether a genetic risk score (GRS) based on 29 newly identified single nucleotide polymorphisms (SNPs) enhances the prediction of adult hypertension. Hypertension in adulthood was defined as systolic BP ≥130mmHg or diastolic BP ≥85mmHg or medication for the condition. Independent childhood risk factors for adult hypertension included individual's own BP (P<0.0001), parental hypertension (P<0.0001), childhood overweight/obesity (P=0.005), low parental occupational status (P=0.003) and high GRS (P<0.0001). Risk assessment based on childhood overweight/obesity status, parental hypertension and parental occupational status was superior in predicting hypertension compared with the approach using data only on childhood BP levels (C-statistics 0.718 vs. 0.733, P=0.0007). Inclusion of both parental hypertension history and data on novel genetic variants for hypertension further improved the C-statistics (0.742, P=0.015).
Conclusions—Prediction of adult hypertension was enhanced by taking into account known physical and environmental childhood risk factors, family history of hypertension and novel genetic variants. A multifactorial approach may be useful in identifying children at high risk for adult hypertension.
- Received December 11, 2011.
- Accepted June 1, 2012.
- Copyright © 2012, American Heart Association, Inc. All rights reserved. Unauthorized use prohibited