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Utility of different blood pressure measurement components in childhood to predict adult carotid intima-media thickness: The i3C Consortium Study

Koskinen, J, Juonala, M, Dwyer, T, Venn, A ORCID: 0000-0001-7090-1398, Petkeviciene, J, Ceponiene, I, Bazzano, L, Chen, W, Sabin, MA, Burns, TL, Viikari, JSA, Woo, JG, Urbina, EM, Prineas, R, Hutri- Kahonen, N, Sinaiko, A, Jacobs Jr, DR, Steinberger, J, Daniels, S, Raitakari, O and Magnussen, CG ORCID: 0000-0002-6238-5730 2019 , 'Utility of different blood pressure measurement components in childhood to predict adult carotid intima-media thickness: The i3C Consortium Study' , Hypertension, vol. 73, no. 2 , pp. 335-341 , doi: 10.1161/HYPERTENSIONAHA.118.12225.

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Abstract

Childhood blood pressure (BP) levels predict adult subclinical atherosclerosis. However, the best childhood BP component for prediction has not been determined. This study comprised 5925 participants aged 3 to 18 years from 6 cohorts who were followed into adulthood (mean follow-up 25.8±6.2 years). Childhood BP was measured by using a standard mercury sphygmomanometer in all cohorts. Study-specific carotid intima-media thickness ≥90th percentile was used to define subclinical atherosclerosis. Per SD change in the predictor, childhood systolic BP (SBP; age- and sex-adjusted odds ratio [95% CI], 1.24 [1.13-1.37]), mean arterial pressure (1.10 [1.07-1.13]), and pulse pressure (1.15 [1.05-1.27]) were associated with increased adulthood intima-media thickness. In age- and sex-adjusted analyses, area under the receiver operating characteristic curves for SBP ( C value [95% CI], 0.677 [0.657-0.704]) showed significantly improved prediction compared with diastolic BP (0.669 [0.646-0.693], P=0.006) or mean arterial pressure (0.674 [0.653-0.699], P=0.01). Pulse pressure provided a C value that was not different from SBP (0.676 [0.653-0.699], P=0.16). Combining different BP components did not improve prediction over SBP measurement alone. Based on the associations with adult carotid intima-media thickness, cut points for elevated SBP were 105 mm Hg for 3- to 6-year-old boys, 108 mm Hg for 3- to 6-year-old girls, 108 mm Hg for 7- to 12-year-old boys, 106 mm Hg for 7- to 12-year-old girls, 123 mm Hg for 13- to 18-year-old boys, and 115 mm Hg for 13- to 18-year-old girls. Our analyses suggest that several childhood BP measurement components are related to adulthood carotid intima-media thickness. Of these, SBP provided the best predictive ability.

Item Type: Article
Authors/Creators:Koskinen, J and Juonala, M and Dwyer, T and Venn, A and Petkeviciene, J and Ceponiene, I and Bazzano, L and Chen, W and Sabin, MA and Burns, TL and Viikari, JSA and Woo, JG and Urbina, EM and Prineas, R and Hutri- Kahonen, N and Sinaiko, A and Jacobs Jr, DR and Steinberger, J and Daniels, S and Raitakari, O and Magnussen, CG
Keywords: arterial pressure, atherosclerosis, blood pressure, epidemiology, pediatrics
Journal or Publication Title: Hypertension
Publisher: Lippincott Williams & Wilkins
ISSN: 0194-911X
DOI / ID Number: 10.1161/HYPERTENSIONAHA.118.12225
Copyright Information:

Copyright 2018 American Heart Association, Inc.

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