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Hypertension. 2016 Jan;67(1):41-7. doi: 10.1161/HYPERTENSIONAHA.115.06395. Epub 2015 Nov 9.

Repeated Blood Pressure Measurements in Childhood in Prediction of Hypertension in Adulthood.

Author information

1
From Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (M.O., J.N., C.G.M., O.T.R.); Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia (C.G.M.); Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland (J.S.A.V., M.J.); Department of Pediatrics, Vaasa Central Hospital, Vaasa, Finland (L.T.); Department of Pediatrics, University of Oulu, Oulu, Finland (L.T.); Department of Clinical Physiology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland (T.L.); Department of Pediatrics, University of Tampere and Tampere University Hospital, Tampere, Finland (N.H.-K.); Department of Pediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland (E.J.); Department of Chronic Disease Prevention, National Institute for Health and Welfare, Turku, Finland (A.J.); Cardiology Department (M.C.) and Department of Endocrinology and Diabetes (M.A.S.), Murdoch Children's Research Institute, Royal Children's Hospital and University of Melbourne, Melbourne, Victoria, Australia; Department of Pediatrics, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora (S.R.D.); and Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland (O.T.R.). mervi.oikonen@utu.fi.
2
From Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (M.O., J.N., C.G.M., O.T.R.); Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia (C.G.M.); Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland (J.S.A.V., M.J.); Department of Pediatrics, Vaasa Central Hospital, Vaasa, Finland (L.T.); Department of Pediatrics, University of Oulu, Oulu, Finland (L.T.); Department of Clinical Physiology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland (T.L.); Department of Pediatrics, University of Tampere and Tampere University Hospital, Tampere, Finland (N.H.-K.); Department of Pediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland (E.J.); Department of Chronic Disease Prevention, National Institute for Health and Welfare, Turku, Finland (A.J.); Cardiology Department (M.C.) and Department of Endocrinology and Diabetes (M.A.S.), Murdoch Children's Research Institute, Royal Children's Hospital and University of Melbourne, Melbourne, Victoria, Australia; Department of Pediatrics, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora (S.R.D.); and Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland (O.T.R.).

Abstract

Hypertension may be predicted from childhood risk factors. Repeated observations of abnormal blood pressure in childhood may enhance prediction of hypertension and subclinical atherosclerosis in adulthood compared with a single observation. Participants (1927, 54% women) from the Cardiovascular Risk in Young Finns Study had systolic and diastolic blood pressure measurements performed when aged 3 to 24 years. Childhood/youth abnormal blood pressure was defined as above 90th or 95th percentile. After a 21- to 31-year follow-up, at the age of 30 to 45 years, hypertension (>140/90 mm Hg or antihypertensive medication) prevalence was found to be 19%. Carotid intima-media thickness was examined, and high-risk intima-media was defined as intima-media thickness >90th percentile or carotid plaques. Prediction of adulthood hypertension and high-risk intima-media was compared between one observation of abnormal blood pressure in childhood/youth and multiple observations by improved Pearson correlation coefficients and area under the receiver operating curve. When compared with a single measurement, 2 childhood/youth observations improved the correlation for adult systolic (r=0.44 versus 0.35, P<0.001) and diastolic (r=0.35 versus 0.17, P<0.001) blood pressure. In addition, 2 abnormal childhood/youth blood pressure observations increased the prediction of hypertension in adulthood (0.63 for 2 versus 0.60 for 1 observation, P=0.003). When compared with 2 measurements, third observation did not provide any significant improvement for correlation or prediction (P always >0.05). A higher number of childhood/youth observations of abnormal blood pressure did not enhance prediction of adult high-risk intima-media thickness. Compared with a single measurement, the prediction of adult hypertension was enhanced by 2 observations of abnormal blood pressure in childhood/youth.

KEYWORDS:

atherosclerosis; blood pressure; follow-up studies; hypertension; risk factors

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