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Combined effects of child and adult elevated blood pressure on subclinical atherosclerosis: The International Childhood Cardiovascular Cohort Consortium
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posted on 2023-05-17, 18:57 authored by Juhola, J, Costan Magnussen, Berenson, GS, Alison VennAlison Venn, Burns, TL, Sabin, MA, Srinivasan, SR, Daniels, SR, Davis, PH, Chen, W, Kahonen, M, Taittonen, L, Urbina, E, Viikari, JSA, Dwyer, T, Raitakari, OT, Juonala, MBACKGROUND - : Elevated blood pressure (BP) levels in childhood have been associated with subsequent atherosclerosis. However, it is uncertain whether this risk is attenuated in individuals who acquire normal BP by adulthood. The present study examined the effect of child and adult BP levels on carotid artery intima-media thickness (IMT) in adulthood. METHODS AND RESULTS - : The cohort consisted of 4210 participants from 4 prospective studies (mean follow-up, 23 years). Childhood elevated BP was defined according to the tables from the National High Blood Pressure Education Program. In adulthood, BP was classified as elevated for individuals with systolic BP ≥120 mm Hg, diastolic BP ≥80 mm Hg or with self-reported use of antihypertensive medications. Carotid artery IMT was measured in the left common carotid artery. High IMT was defined as an IMT ≥90th percentile according to age-, sex-, race-, and cohort-specific levels. Individuals with persistently elevated BP and individuals with normal childhood BP, but elevated adult BP had increased risk of high carotid artery IMT (relative risk [95% confidence interval]) 1.82[1.47-2.38] and 1.57[1.22-2.02], respectively) in comparison with individuals with normal child and adult BP. In contrast, individuals with elevated BP as children but not as adults did not have significantly increased risk (1.24[0.92-1.67]). In addition, these individuals had a lower risk of increased carotid artery IMT (0.66[0.50-0.88]) in compared with those with persistently elevated BP. The results were consistent when controlling for age, sex, and adiposity and when different BP definitions were applied. CONCLUSIONS - : Individuals with persistently elevated BP from childhood to adulthood had increased risk of carotid atherosclerosis. This risk was reduced if elevated BP during childhood resolved by adulthood. © 2013 American Heart Association, Inc.
Funding
National Health & Medical Research Council
History
Publication title
CirculationVolume
128Pagination
217-224ISSN
0009-7322Department/School
Menzies Institute for Medical ResearchPublisher
Lippincott Williams & WilkinsPlace of publication
530 Walnut St, Philadelphia, USA, Pa, 19106-3621Rights statement
Copyright 2013 American Heart AssociationRepository Status
- Restricted
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