Elevated Blood Pressure and Worsening Cardiac Damage During Adolescence - 17/06/23
Abstract |
Objectives |
To examine the longitudinal course for the development of elevated blood pressure (BP)/hypertension and cardiac damage in adolescents.
Study design |
From the Avon Longitudinal Study of Parents and Children, UK birth cohort, 1856 (1011 female) 17-year-old adolescents were followed up for 7 years. BP and echocardiography were assessed at ages 17 and 24 years. Elevated/hypertensive BP was defined as ≥130 mm Hg systolic and ≥85 mm Hg diastolic. Left ventricular (LV) mass indexed for height2.7 (LVMI2.7) ≥51 g/m2.7 was defined as LV hypertrophy (LVH) and LV diastolic function (LVDF) E/A <1.5 as LVD dysfunction (LVDD). Data were analyzed with generalized logit mixed-effect models and cross-lagged structural equation temporal path models adjusting for cardiometabolic and lifestyle factors.
Results |
Over follow-up, the prevalence of elevated systolic BP/hypertension increased from 6.4% to 12.2%, LVH from 3.6% to 7.2%, and LVDD from 11.1% to 16.3%. Cumulative elevated systolic BP/hypertension was associated with worsening LVH in female participants (OR 1.61, CI 1.43-1.80 P < .001) but not in male participants. Elevated systolic BP/hypertension was associated with worsening LVDD in male and female participants. Elevated diastolic BP/hypertension was associated with worsening LVH in male and female participants. In cross-lagged temporal path models, higher baseline systolic BP was associated with LVDF (β = 0.09, SE = 0.002, P = .029) but not LVMI2.7 at follow-up. Higher baseline cardiac indices were not associated with follow-up systolic BP. Higher baseline diastolic BP was associated with follow-up higher cardiac indices except LVDF. Baseline LVMI2.7 was not associated with follow-up diastolic BP.
Conclusions |
Elevated BP/hypertension may temporally precede premature cardiac damage in youth.
Le texte complet de cet article est disponible en PDF.Keywords : adolescence, hypertension, arterial stiffness, left ventricular hypertrophy, left ventricular diastolic dysfunction, health promotion
Abbreviations : ALSPAC, BP, cfPWV, hiLVFP, hiRWT, LVDD, LVDF, LVFP, LVH, LVMI, RWT
Plan
| The UK Medical Research Council and Wellcome (Grant ref: 217065/Z/19/Z) and the University of Bristol provide core support for Avon Longitudinal Study of Parents and Children. The British Heart Foundation grant (CS/15/6/31468) funded blood pressure, carotid-femoral pulse-wave velocity, and ActiGraph activity monitoring device measurement at 24 years. The Medical Research Council grant (MR/M006727/1) supported smoking data collection. A comprehensive list of grant funding is available on the ALSPAC website (grant-acknowledgements.pdf); Dr Agbaje’s research group (UndeRstanding FITness and Cardiometabolic Health In Little Darlings: urFIT-child) was funded by the Jenny and Antti Wihuri Foundation (Grant no: 00180006); the North Savo regional and central Finnish Cultural Foundation (Grant nos: 65191835 and 00200150), Orion Research Foundation sr, Aarne Koskelo Foundation, Antti and Tyyne Soininen Foundation, Paulo Foundation, Paavo Nurmi Foundation, Yrjö Jahnsson Foundation (Grant no: 20217390), and the Finnish Foundation for Cardiovascular Research (Grant no: 220021). The author has no conflicts of interest to disclose. |
Vol 257
Article 113374- juin 2023 Retour au numéro
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