Moderators of blood pressure development from childhood to adulthood: A 10-year longitudinal study

Abstract

Objective: To examine the effect of ethnicity on the development of blood pressure (BP) from childhood into early adulthood within the context of height, sex, adiposity, and socioeconomic status (SES). Study design: Individual growth curves of systolic BP (SBP) and diastolic BP (DBP) were created for 745 black and white male and female youths, with annual assessments over a 10-year period (age range, 4.9-27.5 years). Results: Blacks had higher SBP levels (P <0.01) than whites, respectively. Moreover, black female subjects showed a greater SBP increase over time (P <.05) than white female subjects. Black male and female subjects also showed higher DBP levels (P <.001) than white male and female subjects, respectively, but the rate of change of DBP did not differ. Ethnic differences in BP trajectories persisted after adjusting for SES and/or changes in height and/or adiposity in both male and female subjects. Conclusions: Ethnic differences in SBP become manifest in childhood in girls, in early adolescence in boys, and tend to increase with age. Ethnic differences in DBP become manifest in childhood in both boys and girls and remain stable over time. The ethnic differences cannot be entirely explained by individual differences in SES, growth, or adiposity. Identification of mechanisms responsible for increase of BP in childhood will improve prevention of hypertension in adulthood. (J Pediatr 2002;141:770-9)