Combined Effects of Child and Adult Elevated Blood Pressure on Subclinical Atherosclerosis: The International Childhood Cardiovascular Cohort Consortium

被引:198
作者
Juhola, Jonna [1 ,2 ,3 ,4 ]
Magnussen, Costan G. [1 ,2 ,3 ,4 ,5 ]
Berenson, Gerald S. [6 ]
Venn, Alison [5 ]
Burns, Trudy L. [7 ,8 ]
Sabin, Matthew A. [9 ,10 ]
Srinivasan, Sathanur R. [6 ]
Daniels, Stephen R. [11 ]
Davis, Patricia H. [7 ,8 ]
Chen, Wei [6 ]
Kaehoenen, Mika [12 ,13 ]
Taittonen, Leena [14 ,15 ]
Urbina, Elaine [16 ]
Viikari, Jorma S. A. [1 ,2 ,3 ,4 ]
Dwyer, Terence [9 ]
Raitakari, Olli T. [1 ,2 ,3 ,4 ]
Juonala, Markus [1 ,2 ,3 ,4 ]
机构
[1] Univ Turku, Res Ctr Appl & Prevent Cardiovasc Med, Turku, Finland
[2] Univ Turku, Dept Clin Physiol & Nucl Med, Turku, Finland
[3] Univ Turku, Dept Med, Turku, Finland
[4] Turku Univ Hosp, FIN-20520 Turku, Finland
[5] Univ Tasmania, Menzies Res Inst Tasmania, Hobart, Tas, Australia
[6] Tulane Univ, Tulane Ctr Cardiovasc Hlth, New Orleans, LA 70118 USA
[7] Univ Iowa, Coll Publ Hlth, Dept Epidemiol, Iowa City, IA USA
[8] Univ Iowa, Carver Coll Med, Dept Neurol, Iowa City, IA USA
[9] Murdoch Childrens Res Inst, Melbourne, Vic, Australia
[10] Univ Melbourne, Royal Childrens Hosp, Dept Paediat, Melbourne, Vic, Australia
[11] Univ Colorado, Denver & Hlth Sci Ctr, Dept Pediat, Aurora, CO USA
[12] Univ Tampere, Dept Clin Physiol, FIN-33101 Tampere, Finland
[13] Tampere Univ Hosp, Tampere, Finland
[14] Univ Oulu, Dept Pediat, SF-90100 Oulu, Finland
[15] Vaasa Cent Hosp, Vaasa, Finland
[16] Cincinnati Childrens Hosp, Med Ctr, Dept Pediat, Cincinnati, OH USA
基金
英国医学研究理事会; 芬兰科学院; 美国国家卫生研究院;
关键词
atherosclerosis; blood pressure; hypertension; epidemiology; risk factors; INTIMA-MEDIA THICKNESS; CAROTID-ARTERY INTIMA; RISK-FACTORS; YOUNG FINNS; MIDDLE-AGE; DYSLIPIDEMIA CLASSIFICATIONS; MYOCARDIAL-INFARCTION; DETERMINANTS; HYPERTENSION; ASSOCIATION;
D O I
10.1161/CIRCULATIONAHA.113.001614
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Elevated blood pressure (BP) levels in childhood have been associated with subsequent atherosclerosis. However, it is uncertain whether this risk is attenuated in individuals who acquire normal BP by adulthood. The present study examined the effect of child and adult BP levels on carotid artery intima-media thickness (IMT) in adulthood. Methods and Results The cohort consisted of 4210 participants from 4 prospective studies (mean follow-up, 23 years). Childhood elevated BP was defined according to the tables from the National High Blood Pressure Education Program. In adulthood, BP was classified as elevated for individuals with systolic BP 120 mmHg, diastolic BP 80 mmHg or with self-reported use of antihypertensive medications. Carotid artery IMT was measured in the left common carotid artery. High IMT was defined as an IMT 90th percentile according to age-, sex-, race-, and cohort-specific levels. Individuals with persistently elevated BP and individuals with normal childhood BP, but elevated adult BP had increased risk of high carotid artery IMT (relative risk [95% confidence interval]) 1.82[1.47-2.38] and 1.57[1.22-2.02], respectively) in comparison with individuals with normal child and adult BP. In contrast, individuals with elevated BP as children but not as adults did not have significantly increased risk (1.24[0.92-1.67]). In addition, these individuals had a lower risk of increased carotid artery IMT (0.66[0.50-0.88]) in compared with those with persistently elevated BP. The results were consistent when controlling for age, sex, and adiposity and when different BP definitions were applied. Conclusions Individuals with persistently elevated BP from childhood to adulthood had increased risk of carotid atherosclerosis. This risk was reduced if elevated BP during childhood resolved by adulthood.
引用
收藏
页码:217 / 224
页数:8
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