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Early influences on blood pressure: a study of children aged 5-7 years
P H Whincup1, D G Cook, A G Shaper
1Department of Clinical Epidemiology and General Practice, Royal Free Hospital School of Medicine, London.
Insights
Early life factors like birth weight and maternal age influence childhood blood pressure. Firstborns and children of older mothers or those with a family history of hypertension may have higher blood pressure.
Area of Science:
- Pediatric Health
- Cardiovascular Epidemiology
- Human Development
Background:
- Childhood blood pressure is a critical indicator of cardiovascular health.
- Understanding early life influences on blood pressure is vital for long-term health outcomes.
Purpose of the Study:
- To investigate the association between various early life factors and blood pressure levels in young children.
- To identify key determinants of blood pressure in the first decade of life.
Main Methods:
- A cross-sectional, school-based survey was conducted on 3591 children aged 5.0-7.5 years.
- Data collected included blood pressure measurements, birth weight, birth rank, maternal age, and family history of hypertension.
- Statistical analysis involved standardized regression to assess relationships while controlling for confounding factors.
Main Results:
- Lower birth weight, standardized for current weight, was inversely associated with systolic and diastolic blood pressure.
- Increased maternal age, higher birth rank (firstborn), and maternal history of hypertension were independently associated with higher blood pressure.
- These associations remained significant after adjusting for age, social class, and other factors.
Conclusions:
- Early life exposures, including birth weight and factors related to maternal and birth characteristics, significantly influence blood pressure in early childhood.
- The findings suggest that interventions or awareness regarding factors like birth weight, maternal age, and family history could be important for managing pediatric blood pressure.
- Delayed childbearing and smaller family sizes may be associated with increased offspring blood pressure, warranting further investigation.
Objective:
To examine factors that influence blood pressure in children.
Design:
Cross sectional study of children aged 5.0-7.0 years who had blood pressure measurements and for whom parental questionnaires were completed.
Setting:
School based survey.
Subjects:
3591 Children aged 5.0-7.5 years selected by stratified random sampling of primary schools in nine British towns (response rate 72%); 3591 were examined and their parental questionnaires were completed. Data were complete for birth rank in 3559, maternal age in 3542, maternal history of hypertension in 3524, and paternal history in 2633.
Results:
Birth weight was inversely related to mean systolic blood pressure but only when standardised for current weight (weight standardised regression coefficient -1.83 mm Hg/kg (95% confidence interval -1.31 to -2.35). Mean diastolic pressure was similarly related to birth weight. Maternal age, birth rank, and a parental history of hypertension were all related to blood pressure. After standardisation for current weight a 10 year increase in maternal age was associated with a 1.0 mm Hg (0.4 to 1.6) rise in systolic pressure; first born children had systolic blood pressure on average 2.53 mm Hg (0.81 to 4.25) higher than those whose birth rank was greater than or equal to 4; and a maternal history of hypertension was associated with a systolic pressure on average 0.96 mm Hg (0.41 to 1.51) higher than in those with no such history. The effects described were largely independent of one another and of age and social class. The relation for birth rank was, however, closely related to that for family size.
Conclusions:
Influences acting in early life may be important determinants of blood pressure in the first decade. The relation between birth weight and blood pressure may reflect the rate of weight gain in infancy. The reasons for the relation with birth rank and maternal age are unknown; if confirmed they imply that delayed motherhood and smaller family size may be associated with higher blood pressure in offspring.
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