Utility of Different Blood Pressure Measurement Components in Childhood to Predict Adult Carotid Intima-Media Thickness
Year: 2018
Type: article
Study design: Observational Study
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.
Source: Hypertension
Authors: Juha Koskinen, Markus Juonala, Terence Dwyer, Alison Venn, Janina Petkeviciene, Indrė Čeponienė, Lydia Bazzano, Wei Chen, Matthew A. Sabin, Trudy L. Burns, Jorma S.A. Viikari, Jessica G. Woo, Elaine M. Urbina, Ronald Prineas, Nina Hutri-Kähönen, Alan Sinaiko, David R. Jacobs, Julia Steinberger, Stephen Daniels, Olli Raitakari, Costan G. Magnussen
Institutions: University of Turku, Kymenlaakson keskussairaala, Turku University Hospital, Murdoch Children's Research Institute, University of Oxford, University of Tasmania, Menzies Institute for Medical Research, Lithuanian University of Health Sciences, Tulane University, Royal Children's Hospital, The University of Melbourne, University of Iowa, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Wake Forest University Health Sciences, Wake Forest University, Tampere University Hospital, University of Tampere, University of Minnesota, Children's Hospital Colorado, University of Colorado Anschutz
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: Yrjö Jahnssonin Säätiö, Urmas Pekkalan säätiö, National Heart Foundation of Australia, Kela, Suomen Kulttuurirahasto, Juho Vainion Säätiö, Lietuvos Mokslo Taryba, Emil Aaltosen Säätiö, Paavo Nurmen Säätiö, Turun Yliopistollinen Keskussairaala, Turun Yliopistosäätiö, National Institutes of Health, Medical Research Council, National Health and Medical Research Council, National Heart, Lung, and Blood Institute, National Center for Research Resources
Awards: G1242256790, Childhood CV Risk and Adult CVD Outcomes: an International Long-term Follow-up, General Clinical Research Center, G2350025396, CT VASCULAR CALCIUM-AN EPIDEMIOLOGIC STUDY IN THE YOUNG, G3289800213, G427637532, ARTERIAL ENDOTHELIAL FUNCTION--AN EPIDEMIOLOGIC STUDY, G5212302835, ARTERIAL ENDOTHELIAL FUNCTION--AN EPIDEMIOLOGIC STUDY, G6894421026, G6968042294, Epidemiology of Carotid Artery Atherosclerosis in Youth, Understanding the early-life pathways for adult type 2 diabetes using existing data from seven cohorts of the International Childhood Cardiovascular Cohort (i3C) Consortium, Genetinių ir gyvensenos veiksnių ryšiai, vertinant lėtinių ligų riziką ir jos pokyčius nuo vaikystės
OpenAlex ID: W2908257018