The Associations Between Cumulative Effects of Blood Pressure From Childhood to Adulthood and Adult Subclinical Renal Damage: Hanzhong Adolescent Hypertension Cohort Study

Abstract

Abstract Background To investigate the impact of cumulative effects of systolic and diastolic blood pressures (SBP and DBP) from childhood to adulthood on adult subclinical renal damage (SRD). Methods A baseline survey on height, bodyweight, and blood pressure (BP) of 6- to 15-year-old school students in Hanzhong, Shaanxi, was conducted in 1987. Follow-up was conducted in 1989, 1992, 1995, 2005, 2013, and 2017. A total of 1,553 individuals who had been followed at least 4 times since baseline were included in the study. Blood and urine biochemical indexes were detected during the follow-up period. Renal function was assessed with estimated glomerular filtration rate and urine albumin-to-creatinine ratio. The logistic regression analysis was used to analyze the relationships between cumulative effects or longitudinal trends of BP and adult SRD. Results The proportion of adult SRD in the groups with high BP cumulative effects or longitudinal trends was significantly higher than that in the normal group (cumulative effects: SBP 20.6% vs. 10.3%, P < 0.001 and DBP 22.2% vs. 9.8%, P < 0.001; longitudinal trends: SBP 17.8% vs. 11.2%, P = 0.001 and DBP 19.1% vs. 10.8%, P < 0.001). Multivariate logistic regression showed that the risk of adult SRD in the group with high BP cumulative effects (SBP: OR = 2.07, 95% CI 1.45–2.96, P < 0.001; DBP: OR = 2.25, 95% CI 1.59–3.19, P < 0.001) or high BP longitudinal trends (SBP: OR = 1.43, 95% CI 1.00–2.05, P = 0.049; DBP: OR = 1.50, 95% CI 1.05–2.13, P = 0.026) was significantly higher than that in the normal group, after adjusting for gender, age, body mass index, blood glucose, blood lipid, uric acid and other confounding factors. Conclusions The cumulative effects and longitudinal trends of BP from children to adults significantly increase the risk of adult SRD. Monitoring and controlling BP from childhood is important for long-term kidney health.