Serial Changes in Blood Pressure from Adolescence into Adulthood

High blood pressure is an established risk factor for cardiovascular disease outcomes in adulthood. Furthermore, numerous longitudinal studies of blood pressure in childhood with length of follow-up from 1 to 17 years indicate that blood pressure levels track over the short term. This study addresses the question of the predictive value of childhood blood pressure readings for adult levels, using repeated blood pressure determinations from a sample of 501 participants in the Fels Longitudinal Study, an ongoing cohort study in southwestern Ohio that began in 1929. A damped autoregressive model indicated tracking correlations from 0.39 (4-year intervals) to 0.24 (20 years) for systolic pressure and 0.37 (4 years) to 0.20 (20 years) for diastolic pressure. These results indicate that tracking of blood pressure persists from age 13 years to age 40 years, which translates into moderate levels of relative risk for adult hypertension (diastolic pressure above 90 mmHg) for adolescents with high normal blood pressure. The estimated relative risks of hypertension at age 35 for white 15-year-olds with a true mean diastolic pressure of 80 mmHg were 1.9 for males and 2.6 for females, relative to 15-year-olds with a true diastolic pressure of 60 mmHg.