Dynamic prediction of childhood high blood pressure in a population-based birth cohort: a model development study

Area of Science:

• Pediatrics
• Cardiovascular Health
• Public Health

Background:

• High blood pressure in childhood is a growing concern.
• Early identification of at-risk children is crucial for timely intervention.
• Predictive models can aid in risk stratification within community-based child healthcare.

Purpose of the Study:

• To develop a dynamic prediction model for high blood pressure (hypertension) in children aged 9-10 years.
• The model is designed for application at any point between birth and 6 years of age.
• To enable early, targeted primordial prevention of cardiovascular disease.

Main Methods:

• A prospective cohort study of 5359 children in Rotterdam, Netherlands.
• High blood pressure defined as systolic/diastolic blood pressure ≥95th percentile.
• Multivariable pooled logistic regression used to assess predictive value of birth characteristics and longitudinal body mass index (BMI) SDS up to age 6.

Main Results:

• 227 children (4.2%) had high blood pressure at 9-10 years.
• Key predictors included maternal hypertensive disease, maternal education, maternal prepregnancy BMI, child ethnicity, birth weight SDS, and recent BMI SDS.
• Area under the receiver operating characteristic curve ranged from 0.65 (prediction at age 3) to 0.73 (prediction at age 5-6).

Conclusions:

• A validated prediction model for childhood hypertension is available.
• The model can be used in community child healthcare for risk monitoring.
• Facilitates early, targeted primordial prevention strategies for cardiovascular disease.