Life-Course Blood Pressure Levels, 38-Year Tracking, and Prediction of Hypertension

Elevated childhood blood pressure (BP) levels may persist into adulthood, and persistent exposure to elevated BP since childhood may increase the adulthood risk of hypertension. This study examined the tracking of childhood BP into adulthood over 38 years. We also studied the association between long-term cumulative BP exposure in childhood and adolescence and the risk of developing hypertension in adulthood.

Participants were from the YFS (Cardiovascular Risk in Young Finns Study) that began in 1980 (N=3596; ages 3-18 years). The cohort was remeasured in 1983, 1986, 1989, 2001, 2007, 2011, and 2018 through 2020. In total, 2064 attended the latest study visit (45% men; ages 40-58 years; average follow-up, 38.0 years). BP was measured repeatedly using standard methods. Cumulative BP exposure was defined using area under the curve. Hypertension was defined as systolic BP ≥140 mm Hg, diastolic BP ≥90 mm Hg, self-reported use of antihypertensive medication, or diagnosis of hypertension given by a physician.

A weak correlation was observed between childhood (baseline ages 3-18 years) and adulthood BP (latest follow-up, ages 41-56 years): r=0.298 (P<0.0001) in females and r=0.187 (P<0.0001) in males. Long-term cumulative exposure to elevated BP (highest versus lowest systolic BP quartile) between ages 6 and 12 years was associated with higher risk of hypertension in adulthood both in females (hazard ratio [HR], 3.85 [95% CI, 2.87-5.17]) and in males (HR, 2.66 [95% CI, 2.07-3.42]).

These data indicate that long-term cumulative exposure to elevated BP levels in childhood/adolescence are associated with a substantially increased risk of adult hypertension.