Korean Circ J.  2019 Mar;49(3):223-237. 10.4070/kcj.2018.0448.

Blood Pressure Trajectories from Childhood to Adolescence in Pediatric Hypertension

• Oh JH
• Hong YM

• KMID: 2438533
• DOI: http://doi.org/10.4070/kcj.2018.0448

Abstract

It has been known for a long time that elevated blood pressure (BP) in the young may persist and progress into adult hypertension (HTN). Multiple studies have revealed the predicted BP trajectory lines starting from childhood and related them to later cardiovascular (CV) risks in adulthood. As a small baby grows into a tall adult, BP will also naturally increase. Among early-life predictors of adult HTN, birth history, such as prematurity, and low birth weight have been popular subjects in research on pediatric HTN, because body size at birth has been reported to be inversely related to the risk of adulthood HTN. The hypothesis of HTN in prematurely born adolescents has been postulated as a physiological predisposition to postnatal excessive weight gain. Current body weight is a well-known independent predictor of HTN in children, and some studies showed that children demonstrating upward crossing of their weight percentiles while growing into adolescents have significantly increased risk for elevated BP later in life. Recently, reports focused on the adverse effect of excessive catch-up growth in this population are gradually drawing attention. Accordingly, children born prematurely or with intrauterine growth restriction who show rapid changes in their weight percentile should be under surveillance with BP monitoring. Prevention of childhood obesity, along with special care for premature infants or infants small for their gestational age, by providing healthy nutritional guidelines should be cardinal strategies for the prevention of adult HTN and CV risks later in life.

Keyword

Blood pressure; Hypertension; Children; Low birth weight; Infant, premature

MeSH Terms

Adolescent*
Adult
Blood Pressure*
Body Size
Body Weight
Child
Gestational Age
Humans
Hypertension*
Infant
Infant, Low Birth Weight
Infant, Newborn
Infant, Premature
Parturition
Pediatric Obesity
Reproductive History
Weight Gain

Figure

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  Figure 1 Plot of predicted trajectory lines with 95% confidence intervals for the 4 blood pressure trajectory groups identified in a general population longitudinal birth cohort. Reproduced with permission from Wolters Kluwer, Theodore RF, et al. Hypertension 2015;66:1108-15.4)

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