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Blood pressure during the first two years of life
Insights
This study tracked infant blood pressure (BP) from birth to two years. Most infants showed stable BP, but a small group consistently had high readings, indicating potential early hypertension risk.
Area of Science:
- Pediatrics
- Cardiovascular Health
- Infant Development
Background:
- Establishing normative blood pressure (BP) ranges in infants is crucial for early detection of cardiovascular risks.
- Longitudinal data on infant BP development is essential for understanding growth patterns and potential deviations.
Purpose of the Study:
- To longitudinally track blood pressure (BP) in healthy infants from the third postnatal day to 24 months of age.
- To investigate the relationship between BP and factors such as race, socioeconomic status, sex, and physical growth.
- To identify infants with persistently elevated BP readings over time.
Main Methods:
- Longitudinal study measuring BP in 392 healthy, full-term infants at multiple time points: postnatal day 3, 6 months, 15 months, and 24 months.
- BP measurements were taken during sleep, with adjustments for waking differences at 24 months.
- Statistical analyses examined variations in BP based on demographic factors and physical maturation (weight, height).
Main Results:
- Small average BP differences were observed between white and black infants; BP did not significantly vary with socioeconomic class or sex.
- Infant BP increased from birth to six months but remained stable from six to 24 months, despite significant physical growth.
- A persistent group (5%) exhibited systolic BPs above the 80th percentile at all measurement points, showing similar physical maturation to the cohort average.
Conclusions:
- Infant blood pressure generally stabilizes after six months of age, irrespective of rapid growth.
- A small subset of infants demonstrates persistently elevated BP, warranting further investigation for early hypertension.
- The findings highlight the importance of longitudinal BP monitoring in infancy to identify at-risk individuals.
Abstract:
Blood pressure (BP) was measured on the third postnatal day in 392 healthy, full-term, appropriate weight infants, and again in 318 infants at six months, in 277 infants at 15 months, and in 232 infants at 24 months of age. Differences in average BP between white infants and black infants were small; BP did not vary significantly as a function of socioeconomic class or sex. BP, measured during sleep, had increased from birth to six months of age, but showed no change from six to 15 months, a period of rapid growth, during which average weight increased 37% and average height increased 16%. BP continued to show to change from 15 to 24 months, when waking BP measurements at 24 months were adjusted for sleep-waking differences in BP. Cross-sectional and analyses revealed only modest weight-BP relationships at 15 and 24 months. Five per cent of the infants exhibited systolic BPs which remained above the 80th percentile at six, 15, and 24 months of age. This was six times the number expected by chance if BP was assumed to be uncorrelated from measurement to measurement. This group of infants showed physical maturation, measured by weight change, which was almost identical with that of the total cohort.