Lifecourse Adiposity and Blood Pressure Between Birth and 17 Years Old

Childhood obesity creates a predisposition to develop adult hypertension and diabetes. We have identified distinct childhood adiposity trajectories associated with increased insulin resistance in early adolescence. Our aim was to investigate the relationship between these adiposity trajectories with childhood blood pressure (BP) development.

Adiposity trajectories were previously developed by semiparametric modeling using serial anthropometry from birth to age 14 from the West Australian Pregnancy Cohort. The association between these trajectories and the prevalence of hypertension and prehypertension in 17 year olds was assessed by logistic regression. The relationship between adiposity trajectories and lifecourse BP was then assessed using linear mixed modeling.

The study includes 1,023 adolescents with BP measured at age 17 years. Three of 7 childhood adiposity trajectories (with accelerating adiposity) previously related to increased insulin resistance were associated with an increased risk of 17-year-old prehypertension or hypertension, compared to a referent trajectory of "stable average adiposity" (odds ratio (OR) = 2.9, P = 0.007; OR = 3.5, P < 0.001; and OR = 1.8, P = 0.041). One decelerating adiposity trajectory from high birth size was associated with significant interactions with age terms (P values = 0.025-0.084 and 0.011-0.027), indicating an altered slope and therefore, relative decline in lifecourse BP compared to the reference adiposity trajectory.

Adiposity trajectories (which comprise 27% of the population) were associated with an increased risk of hypertension/prehypertension in adolescence. Higher BP was detectable as early as 3 years old. Consequently, targeting fat loss (catch-down growth) in the preschool years may prevent the development of hypertension and related metabolic disorders.