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Utility of different blood pressure measurement components in childhood to predict adult carotid intima-media thickness: The i3C Consortium Study

journal contribution
posted on 2023-05-20, 01:30 authored by Koskinen, J, Juonala, M, Dwyer, T, Alison VennAlison Venn, Petkeviciene, J, Ceponiene, I, Bazzano, L, Chen, W, Sabin, MA, Burns, TL, Viikari, JSA, Woo, JG, Urbina, EM, Prineas, R, Hutri- Kahonen, N, Sinaiko, A, Jacobs Jr, DR, Steinberger, J, Daniels, S, Raitakari, O, Costan Magnussen
Childhood blood pressure (BP) levels predict adult subclinical atherosclerosis. However, the best childhood BP component for prediction has not been determined. This study comprised 5925 participants aged 3 to 18 years from 6 cohorts who were followed into adulthood (mean follow-up 25.8±6.2 years). Childhood BP was measured by using a standard mercury sphygmomanometer in all cohorts. Study-specific carotid intima-media thickness ≥90th percentile was used to define subclinical atherosclerosis. Per SD change in the predictor, childhood systolic BP (SBP; age- and sex-adjusted odds ratio [95% CI], 1.24 [1.13-1.37]), mean arterial pressure (1.10 [1.07-1.13]), and pulse pressure (1.15 [1.05-1.27]) were associated with increased adulthood intima-media thickness. In age- and sex-adjusted analyses, area under the receiver operating characteristic curves for SBP ( C value [95% CI], 0.677 [0.657-0.704]) showed significantly improved prediction compared with diastolic BP (0.669 [0.646-0.693], P=0.006) or mean arterial pressure (0.674 [0.653-0.699], P=0.01). Pulse pressure provided a C value that was not different from SBP (0.676 [0.653-0.699], P=0.16). Combining different BP components did not improve prediction over SBP measurement alone. Based on the associations with adult carotid intima-media thickness, cut points for elevated SBP were 105 mm Hg for 3- to 6-year-old boys, 108 mm Hg for 3- to 6-year-old girls, 108 mm Hg for 7- to 12-year-old boys, 106 mm Hg for 7- to 12-year-old girls, 123 mm Hg for 13- to 18-year-old boys, and 115 mm Hg for 13- to 18-year-old girls. Our analyses suggest that several childhood BP measurement components are related to adulthood carotid intima-media thickness. Of these, SBP provided the best predictive ability.

History

Publication title

Hypertension

Volume

73

Pagination

335-341

ISSN

0194-911X

Department/School

Menzies Institute for Medical Research

Publisher

Lippincott Williams & Wilkins

Place of publication

530 Walnut St, Philadelphia, USA, Pa, 19106-3621

Rights statement

Copyright 2018 American Heart Association, Inc.

Repository Status

  • Restricted

Socio-economic Objectives

Clinical health not elsewhere classified

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