Key result
A high increasing BMI trajectory from childhood to puberty was associated with an increased risk of high blood pressure compared to a normal increasing trajectory (adjusted HR 1.56; 95% CI 1.02-2.38).
Why the study?
Childhood hypertension is increasing alongside childhood overweight and obesity, but how growth trajectories from childhood to puberty relate to high blood pressure remains poorly defined.
Does a high increasing BMI trajectory from childhood to puberty increase the risk of developing high blood pressure compared to a normal increasing trajectory?
Cohort (n=1,907)
Yes
Does a high increasing BMI trajectory from childhood to puberty increase the risk of developing high blood pressure compared to a normal increasing trajectory?
Hazard Ratio: 1.56 (95% CI 1.02–2.38)
A high increasing BMI trajectory from childhood to puberty significantly increases the risk of developing high blood pressure, highlighting puberty as a critical window for cardiovascular risk mitigation.
May support identifying at-risk youth via BMI trajectories; leaves open need for prospective trials.
OBJECTIVES: The prevalence of childhood hypertension is rising in parallel with the increasing prevalence of overweight and obesity in children. How growth trajectories from childhood to puberty relate to high blood pressure (HBP) is not well defined. We aimed to characterise potential body mass index (BMI) dynamic changing trajectories from childhood to puberty and investigate their association with HBP. DESIGN: A dynamic prospective cohort. SETTING: China Health and Nutrition Survey 1991-2015. PARTICIPANTS: There were 1907 participants (1027 men and 880 women) in this study. OUTCOMES: The primary outcome was HBP defined as systolic blood pressure (SBP)/diastolic blood pressure (DBP) exceeding the standards or diagnosis by medical records or taking antihypertensive medication. RESULTS: A model of cubic parameters with three groups was chosen, labelled as normal increasing group (85.16%, n=1624), high increasing group (9.81%, n=187) and resolving group (5.03%, n=96). Compared with the normal increasing group, the unadjusted HRs (95% CIs) for the resolving and high increasing groups were 0.91 (0.45 to 1.86) and 1.88 (1.26 to 2.81), respectively. After adjusting for baseline age, region, sex, baseline BMI z-score, baseline SBP and baseline DBP in model 3, the HRs (95% CIs) for the resolving and high increasing groups were 0.66 (0.30 to 1.45) and 1.56 (1.02 to 2.38). CONCLUSIONS: These results indicate that the BMI trajectories from childhood to puberty have significant impact on HBP risk. Puberty is a crucial period for the development of HBP.
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Ji et al. (2021) conducted a cohort in High blood pressure (n=1,907). High increasing BMI trajectory vs. Normal increasing BMI trajectory was evaluated on High blood pressure defined as SBP/DBP exceeding standards, diagnosis by medical records, or taking antihypertensive medication (HR 1.56, 95% CI 1.02-2.38). A high increasing BMI trajectory from childhood to puberty was associated with an increased risk of high blood pressure compared to a normal increasing trajectory (adjusted HR 1.56; 95% CI 1.02-2.38).
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