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Repeated high blood pressure at 6 and 11 years at the Pelotas 2004 birth cohort study
Marília Cruz Guttier1, Raquel Siqueira Barcelos2, Rodrigo Wiltgen Ferreira3
1Postgraduate Program in Epidemiology, Federal University of Pelotas (UFPel), Cep: 96020-220 - Caixa Postal 464, Rua Marechal Deodoro, 1160 - 3° Piso. Bairro Centro, Pelotas, Rio Grande do Sul, Brazil. maguttier@gmail.com.
Insights
Repeated high blood pressure in children is linked to maternal gestational diabetes, obesity, family history of hypertension, and prematurity. These factors increase the risk of elevated systolic and diastolic blood pressure over time.
Area of Science:
- Pediatrics
- Cardiovascular Health
- Epidemiology
Background:
- Study on the prevalence and associated factors of repeated high blood pressure in children.
- Utilized data from the Pelotas (Brazil) 2004 Birth Cohort.
Purpose of the Study:
- To evaluate the prevalence of repeated high systolic (SBP) and diastolic blood pressure (DBP).
- To identify factors associated with persistent elevated blood pressure in children at 6- and 11-year follow-ups.
Main Methods:
- Enrolled all live births to mothers in Pelotas' urban area.
- Transformed blood pressure (BP) values into Z-scores by sex, age, and height.
- Defined high SBP/DBP as repeated BP Z-scores on the ≥95th percentile at two follow-ups; analyzed associations using logistic regression.
Main Results:
- Prevalence of repeated high SBP was 1.7%, DBP was 2.3%, and both (SDBP) was 1.2%.
- High SBP associated with males, gestational diabetes mellitus, and childhood obesity.
- High DBP associated with females, family history of hypertension, and preterm birth (<34 weeks gestation).
Conclusions:
- Prevalence of repeated high blood pressure was within expected population distributions.
- Gestational diabetes mellitus, obesity, family history of hypertension, and prematurity are significant risk factors for sustained high blood pressure in children.
- These findings highlight critical early-life factors influencing long-term cardiovascular health.
Background:
We evaluated the prevalence and the factors associated with repeated high systolic (SBP) and diastolic blood pressure (DBP) at 6- and 11-year follow-ups of children from the Pelotas (Brazil) 2004 Birth Cohort.
Methods:
All live births to mothers living in the urban area of Pelotas were enrolled in the cohort. Blood pressure (BP) values were transformed into Z-scores by sex, age, and height. High SBP and DBP were defined as repeated systolic and diastolic BP Z-scores on the ≥95th percentile at the two follow-ups. Prevalence (95% confidence interval) of repeated high SBP, DBP, and both (SDBP) were calculated. Associations with maternal and child characteristics were explored in crude and adjusted logistic regression analyses.
Results:
A total of 3182 cohort participants were analyzed. Prevalence of repeated high SBP, DBP and SDBP was 1.7% (1.2-2.1%), 2.3% (1.8-2.9%) and 1.2% (0.9-1.6%), respectively. Repeated high SBP was associated with males, gestational diabetes mellitus (2.92; 1.13-7.58) and obesity at 11 years (2.44; 1.29-4.59); while repeated high DBP was associated with females, family history of hypertension from both sides (3.95; 1.59-9.85) and gestational age < 34 weeks (4.08; 1.52-10.96). Repeated high SDBP was not associated with any of the characteristics investigated.
Conclusion:
Prevalence of repeated high SBP, DBP, and SDBP were within the expected distribution at the population level. Nonetheless, gestational diabetes mellitus, obesity, family history of hypertension, and prematurity increased the risk of repeated high blood pressure measured at two occasions 5 years apart.
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