Objective To investigate the effect of childhood high blood pressure (BP) on the risk of hypertension in adulthood, in order to provide evidence for the early prevention of high BP in adults.
Methods Based on the data from the China Health and Nutrition Survey (CHNS, 1991-2011), a total of 1 984 subjects aged 6 to 17 years and followed up from childhood (6-17 years) to young adulthood (18-38 years) with complete data were included. In childhood, elevated BP was defined as systolic and/or diastolic BP (SBP/DBP) ≥P
90 cut-off value and<P
95 cut-off value for sex and age, and high BP as SBP and/or DBP≥P
95 cut-off value for age and sex according to the references of high blood pressure in Chinese children and adolescents. In adulthood, pre-hypertension was defined as SBP/DBP≥120/80 mmHg and<140/90 mmHg, and hypertension as SBP/DBP≥140/90 mmHg, or having hypertension history or self-reported use of antihypertensive medications. Covariance analysis and Cox proportional hazards models were used to assess the influence of childhood elevated and high BP on the risk of development of pre-hypertension and hypertension in adulthood, with adjustment for sex and age in childhood, and body mass index (BMI), smoking status and alcohol intake in adulthood.
Results Totally 1 984 subjects aged 6 to 17 years were included, with a median follow-up duration of 11.7 years. There were 108 (5.4%) subjects with elevated BP and 199(10.0%) subjects with high BP at childhood baseline. In adulthood, there were 697(35.1%) subjects with pre-hypertension and 104(5.2%) subjects with hypertension. After adjusting for confounding factors, SBP and DBP levels in adulthood increased with the increase of BP percentiles in childhood (
Pfor trend<0.001). Children with high BP had an increased risk of pre-hypertension in adulthood (
HR=1.41, 95%
CI: 1.12-1.77) and hypertension in adulthood (
HR=1.73, 95%
CI: 1.01-2.98).
Conclusions Childhood high BP increases risk of pre-hypertension and hypertension in adulthood. It is important to monitor BP status in childhood and to prevent and control high BP during this period, so as to reduce the risk of hypertension in adulthood.
Key words
childhood /
adulthood /
hypertension /
cohort study
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