Abstract

Elevated blood pressure in children is a significant risk factor for the development of cardiovascular disease in adulthood. We examined how children's body mass index (BMI), physical activity and sedentary time at ages 9 and 11 are associated with blood pressure at age 11. Data were from 1283 children from Bristol, UK, who participated in the study aged 11 years, 797 of whom also participated in the study aged 9 years. Child height, weight and blood pressure were measured, and children wore accelerometers for five days, from which moderate-to-vigorous-intensity physical activity and sedentary minutes per day were derived. Multiple imputation of missing data and adjusted linear and logistic regression models were used to examine associations. Child BMI at 11 years was cross-sectionally associated with higher systolic and diastolic blood pressure (mean difference [95% confidence interval]: 0.91 [0.32 to 1.50] mm Hg and 1.08 [0.54 to 1.62] mm Hg, respectively, per standard deviation (SD) of BMI). BMI at age 9 was also positively associated with diastolic blood pressure at age 11 (1.16 mmHg per two years [0.49 to 1.84], per SD of BMI). For girls, sedentary time at age 9 years was associated with increased odds of having high systolic blood pressure at age 11 (odds ratio: 1.08 [1.01 to 1.16], per 10 minutes per day). There was no evidence of associations between sedentary time and blood pressure among boys. Similarly, there was little evidence that physical activity was associated with blood pressure in either cross-sectional or prospective analyses. Effective strategies are needed to prevent excess bodyweight among children in order to reduce cardiovascular disease risk.

Highlights

  • Elevated blood pressure in children is a significant risk factor for the development of cardiovascular disease in adulthood

  • A one standard deviation increase in body mass index (BMI) was associated with increases of 0.91 and 1.08 mm Hg for systolic and diastolic blood pressure, respectively, in the confounderadjusted models

  • These findings suggest that while greater BMI during middle childhood may influence the future risk of higher diastolic blood pressure, interventions aimed at increasing physical activity and reducing sedentary time are unlikely to impact the development of cardiovascular disease risk during childhood

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Summary

Introduction

Elevated blood pressure in children is a significant risk factor for the development of cardiovascular disease in adulthood. Higher childhood blood pressure tracks through to adulthood [4] and is positively associated with the development of cardiovascular disease later in life and risk of premature mortality [5,6,7,8,9,10]. Children whose overweight and obesity persist into adulthood are at an increased risk of hypertension, type 2 diabetes, dyslipidemia, and carotid-artery atherosclerosis compared to children who are normal weight [13]. Prospective studies with blood pressure measures at baseline and follow-up, enabling adjustment for baseline blood pressure, would be valuable to gain a better understanding of whether higher BMI is a risk factor for higher blood pressure in children

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