Format

Send to

Choose Destination
Hypertension. 2019 Feb;73(2):335-341. doi: 10.1161/HYPERTENSIONAHA.118.12225.

Utility of Different Blood Pressure Measurement Components in Childhood to Predict Adult Carotid Intima-Media Thickness.

Author information

1
From the Research Centre of Applied and Preventive Cardiovascular Medicine (J.K., O.R., C.G.M.), University of Turku, Finland.
2
Heart Center, Kymenlaakso Central Hospital, Kotka, Finland (J.K.).
3
Department of Medicine (M.J., J.S.A.V.), University of Turku, Finland.
4
Division of Medicine (M.J., J.S.A.V.), Turku University Hospital, Finland.
5
Murdoch Childrens Research Institute, Parkville, Victoria, Australia (M.J.).
6
George Institute, University of Oxford, United Kingdom (T.D.).
7
Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (A.V., C.G.M.).
8
Faculty of Public Health, Medical Academy (J.P.), Lithuanian University of Health Sciences, Kaunas.
9
Department of Cardiology, Medical Academy (I.C.), Lithuanian University of Health Sciences, Kaunas.
10
Department of Epidemiology and Department Biostatistics and Bioinformatics, Tulane University Health Sciences Center (L.B.), Tulane University, New Orleans, LA.
11
Department of Epidemiology, Tulane Center for Cardiovascular Health (W.C.), Tulane University, New Orleans, LA.
12
Royal Children's Hospital, Parkville, Australia (M.A.S.).
13
Department of Pediatrics, University of Melbourne, Parkville, Australia (M.A.S.).
14
Department of Epidemiology, College of Public Health, University of Iowa (T.L.B.).
15
Division of Biostatistics and Epidemiology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, OH (J.G.W.).
16
The Heart Institute, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, OH (E.M.U.).
17
Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (R.P.).
18
Department of Pediatrics, University of Tampere School of Medicine and Tampere University Hospital, Finland (N.H.-K.).
19
Department of Pediatrics (A.S.), University of Minnesota, Minneapolis.
20
Division of Epidemiology and Community Health, School of Public Health (D.R.J.), University of Minnesota, Minneapolis.
21
Department of Pediatrics, University of Minnesota Masonic Children's Hospital (J.S.).
22
Department of Pediatrics, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora (S.D.).
23
Department of Clinical Physiology and Nuclear Medicine, University of Turku (O.R.), Turku University Hospital, Finland.

Abstract

Childhood blood pressure (BP) levels predict adult subclinical atherosclerosis. However, the best childhood BP component for prediction has not been determined. This study comprised 5925 participants aged 3 to 18 years from 6 cohorts who were followed into adulthood (mean follow-up 25.8±6.2 years). Childhood BP was measured by using a standard mercury sphygmomanometer in all cohorts. Study-specific carotid intima-media thickness ≥90th percentile was used to define subclinical atherosclerosis. Per SD change in the predictor, childhood systolic BP (SBP; age- and sex-adjusted odds ratio [95% CI], 1.24 [1.13-1.37]), mean arterial pressure (1.10 [1.07-1.13]), and pulse pressure (1.15 [1.05-1.27]) were associated with increased adulthood intima-media thickness. In age- and sex-adjusted analyses, area under the receiver operating characteristic curves for SBP ( C value [95% CI], 0.677 [0.657-0.704]) showed significantly improved prediction compared with diastolic BP (0.669 [0.646-0.693], P=0.006) or mean arterial pressure (0.674 [0.653-0.699], P=0.01). Pulse pressure provided a C value that was not different from SBP (0.676 [0.653-0.699], P=0.16). Combining different BP components did not improve prediction over SBP measurement alone. Based on the associations with adult carotid intima-media thickness, cut points for elevated SBP were 105 mm Hg for 3- to 6-year-old boys, 108 mm Hg for 3- to 6-year-old girls, 108 mm Hg for 7- to 12-year-old boys, 106 mm Hg for 7- to 12-year-old girls, 123 mm Hg for 13- to 18-year-old boys, and 115 mm Hg for 13- to 18-year-old girls. Our analyses suggest that several childhood BP measurement components are related to adulthood carotid intima-media thickness. Of these, SBP provided the best predictive ability.

KEYWORDS:

arterial pressure; atherosclerosis; blood pressure; epidemiology; pediatrics

PMID:
30580683
PMCID:
PMC6326843
[Available on 2020-02-01]
DOI:
10.1161/HYPERTENSIONAHA.118.12225

Supplemental Content

Full text links

Icon for Atypon
Loading ...
Support Center