BLOOD PRESSURE TRAJECTORIES IN EARLY LIFE ARE ASSOCIATED WITH TARGET ORGAN DAMAGE IN MIDDLE AGE

Abstract

Objective: Hypertension is a pivotal factor in target organ damage (TOD). However, the association of longitudinal BP trajectories in the early life course and adult risk for TOD is poorly reported. Design and method: In a prospective cohort, we identified BP trajectories from early childhood to middle age using group-based trajectory models among 2430 individuals in the Hanzhong Adolescent Hypertension Study (HAHS) and examined the relationship between BP trajectories and TOD risk in later life. Results: Four discrete long-term SBP, DBP and MAP trajectories were identified, namely, low stable, moderate stable, high stable (low increasing), and moderate increasing groups, based on the BP levels at baseline and in the 30-year follow-up. The brachial-ankle pulse wave velocity (baPWV), carotid intima–media thickness (cIMT), urinary albumin-to-creatinine ratio (uACR) were higher in persistently high or increasing trajectories in comparison to the low stable group. Individuals with deteriorative trajectories during early life were at an increased risk of suffering from a single or combined TOD in middle age (36–49 years old). Conclusions: Higher longitudinal SBP, DBP and MAP trajectories early in life were associated with increased TOD risk in midlife. Identifying BP trajectories in early life can help screen individuals with a single or multiple TODs later.