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Childhood predictors of future blood pressure
R M Lauer1, T L Burns, W R Clarke
1Department of Pediatrics, University of Iowa, Iowa City 52242.
Insights
Children with high blood pressure, family history, or obesity may be at risk for adult hypertension. Genetic factors influencing obesity play a significant role in elevated blood pressure for both children and adults.
Area of Science:
- Pediatrics
- Cardiology
- Genetics
Background:
- Childhood blood pressure is lower than adult levels.
- Elevated blood pressure in children may predict future hypertension.
- Hypertension risk factors in childhood include family history, diet, and weight.
Purpose of the Study:
- To investigate factors contributing to elevated blood pressure in children and adults.
- To explore the role of genetics in obesity and its link to hypertension.
- To identify predictors of future hypertension in pediatric populations.
Main Methods:
- Analysis of blood pressure and heart rate responses to mental challenges.
- Assessment of maximal exercise systolic blood pressure and left ventricular mass.
- Evaluation of body mass index (BMI) and its correlation with genetic factors and non-genetic influences.
Main Results:
- Family history of hypertension amplifies blood pressure and heart rate responses to stress, especially with high salt intake.
- Increased maximal exercise systolic blood pressure and left ventricular wall mass in childhood predict future high blood pressure.
- Obesity in both children and adults is associated with significantly higher blood pressures compared to lean individuals. Genetic factors explain a substantial portion of BMI variability, linking obesity to hypertension.
Conclusions:
- Childhood factors like family history, diet, weight gain, and physiological responses are crucial in predicting adult hypertension.
- Genetic predisposition to obesity is a significant contributor to elevated blood pressure in both pediatric and adult populations.
- Early identification and management of these risk factors are essential for preventing hypertension.
Abstract:
Blood pressure in infants and children is much lower than that in adults. It is suspected that children whose blood pressures are greatest for their age or body size may be destined for future hypertension. However, it is apparent that some children with lower blood pressures are also destined for hypertension as adults. Children with a family history of hypertension demonstrate greater blood pressure and heart rate responses to mental challenge. These responses are enhanced when a high salt diet is consumed. Increased maximal exercise systolic blood pressure and increased left ventricular wall mass in childhood add significantly to the prediction of future high blood pressure. In addition, the acquisition of excess weight for height from childhood to young adult life adds to the prediction of future blood pressure elevations. Both children and adults who are obese have significantly higher blood pressures than those who are lean. Approximately 34% of the variability in body mass index is explained by genotype differences at a single recessive locus, 41% by genotype differences at polygenic loci, and 25% by nongenetic factors. Thus, the genetic influence of obesity may be an important factor responsible for elevated blood pressure in both children and adults.