Are childhood blood pressure changes linked to hypertension in adulthood?

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The study examined blood pressure (BP) trajectories from childhood across Black–white and sex groups, and whether childhood BP trajectories independent of childhood BP level were associated with adult hypertension. The longitudinal cohort included 2,732 adults whose body mass index (BMI) and BP were measured 4 to 15 times from childhood (ages 4–19) through adulthood (ages 20–51). Using growth curve parameters and their first derivatives, respectively, the researchers calculated model-estimated BP and BMI levels and linear slopes at childhood age points at one-year intervals.

Linear and nonlinear curve parameters differed significantly across race–sex groups, and BP levels differed by race and sex from age 15 onward. Within race–sex groups, people with hypertension had higher long-term BP levels than those with normal BP. Although linear and nonlinear BP slope parameters were specific to race and sex, they differed consistently and significantly between the hypertension and normal-BP groups. BP trajectories were significantly greater in people with hypertension than in those with normal BP during young adulthood (ages 20–35), but significantly smaller during middle-aged adulthood (ages 36–51).

After adjustment for covariates, level-independent linear slopes of systolic BP were significantly negatively associated with adult hypertension during prepuberty (ages 4–11; odds ratios 0.50–0.76; P <0.001), but significantly positively associated during puberty (ages 13–19; odds ratios 1.44–2.80; P <0.001). These associations were consistent across race–sex groups. The researchers concluded that adult hypertension originates in childhood and that young- and middle-adult BP trajectory profiles differ across Black–white and sex groups. They identified puberty as a crucial period for the development of hypertension later in life.