Abstract
Background. Longitudinal investigations into the origins of adult essential hypertension have found elevated blood pressure in children to accurately track into adulthood, however the direct causes of essential hypertension in adolescence and adulthood remains unclear.Methods. We revisited 152 Peruvian adolescents from a birth cohort tracked from 0 to 30 months of age, and evaluated growth via monthly anthropometric measurements between 1995 and 1998, and obtained anthropometric and blood pressure measurements 11–14 years later. We used multivariable regression models to study the effects of infantile and childhood growth trends on blood pressure and central obesity in early adolescence.Results. In regression models adjusted for interim changes in weight and height, each 0.1 SD increase in weight for length from 0 to 5 months of age, and 1 SD increase from 6 to 30 months of age, was associated with decreased adolescent systolic blood pressure by 1.3 mm Hg (95% CI −2.4 to −0.1) and 2.5 mm Hg (95% CI −4.9 to 0.0), and decreased waist circumference by 0.6 (95% CI −1.1 to 0.0) and 1.2 cm (95% CI −2.3 to −0.1), respectively. Growth in infancy and early childhood was not significantly associated with adolescent waist-to-hip ratio.Conclusions. Rapid compensatory growth in early life has been posited to increase the risk of long-term cardiovascular morbidities such that nutritional interventions may do more harm than good. However, we found increased weight growth during infancy and early childhood to be associated with decreased systolic blood pressure and central adiposity in adolescence.
Highlights
The prevalence of hypertension has increased dramatically in the past two decades among adults in developing nations (Kearney et al, 2004) and globally among adolescents and children (McNiece et al, 2007; Stranges & Cappuccio, 2007; Jackson, Thalange & Cole, 2007)
We found no differences in early change in height (p = 0.387) or weight (p = 0.834), maternal height (p = 0.172), the percentage of households without sewage connection (p = 0.077) or in the type of house flooring (p = 0.860) between the 147 participants who completed follow-up and the remaining 49 (25%) participants of the original cohort that met inclusion criteria but did not participate in the follow-up assessments
Our longitudinal study aimed to assess the effects of early growth on adolescent blood pressure and central adiposity by taking advantage of serial measurement of anthropometric indicators, with data accruing monthly for a period of up to 30 months, and overcoming limitations posed by single ascertainment of birth weight or modelling techniques that approximate growth patterns
Summary
The prevalence of hypertension has increased dramatically in the past two decades among adults in developing nations (Kearney et al, 2004) and globally among adolescents and children (McNiece et al, 2007; Stranges & Cappuccio, 2007; Jackson, Thalange & Cole, 2007). Longitudinal investigations into the origins of adult essential hypertension have found elevated blood pressure in children to accurately track into adulthood (Bao et al, 1995), the direct causes of essential hypertension in adolescence and adulthood remains unclear. Longitudinal investigations into the origins of adult essential hypertension have found elevated blood pressure in children to accurately track into adulthood, the direct causes of essential hypertension in adolescence and adulthood remains unclear. We found increased weight growth during infancy and early childhood to be associated with decreased systolic blood pressure and central adiposity in adolescence
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