High childhood BP predicts adult heart disease

High blood pressure (BP) in childhood increases the likelihood of elevated BP and atherosclerosis in adulthood, and it doesn’t matter which of 3 definitions of childhood high BP you use.

Researchers from Finland looked at the ability of childhood elevated BP to predict high pulse wave velocity, which is a marker for cardiovascular disease. They studied 1,241 children from the Cardiovascular Risk in Young Finns Study who were between the ages of 6 and 15 years in 1980. They then followed them for 27 years.

They used 3 different definitions of childhood high BP: the one that is used by the National Heart, Lung, and Blood Institute in its Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents, which considers age, gender, and height; and 2 simpler definitions more recently proposed that are based strictly on age alone or on age and gender.

The investigators found that childhood high BP-regardless of which definition was used-had a significant relationship with adult cardiovascular disease. In fact, the relative risks for a high pulse wave being associated with elevated pediatric BP was between 1.5 and 1.7 for all 3 definitions.

Approximately half of the children had high BP regardless of the definition used, although the percentage was lowest using the NHLBI’s definition. After 27 years, about 20% of the participants had a high pulse wave velocity; they were the same people who had significantly higher BP values and higher rates of elevated BP at baseline.

NHLBI recommends blood pressure screening at all pediatric visits beginning at age 3 years.