Higher cumulative systolic blood pressure load from childhood to midlife was associated with an increased risk of advanced cardiovascular-kidney-metabolic syndrome (OR 3.75; 95% CI 2.77-5.09).
Cohort (n=1,803)
Does higher cumulative blood pressure load from childhood to midlife increase the risk of advanced cardiovascular-kidney-metabolic syndrome in midlife?
Higher life-course cumulative blood pressure load from childhood is independently associated with a progressively increased risk of advanced cardiovascular-kidney-metabolic syndrome in midlife.
Odds Ratio: 3.75 (95% CI 2.77–5.09)
Objective: Cardiovascular-kidney-metabolic (CKM) syndrome, recently proposed by the American Heart Association, aims at the early prevention of cardiovascular disease. Although elevated blood pressure (BP) is a key modifiable risk factor, the association between cumulative BP load from childhood to midlife and CKM syndrome remains unclear. Design and method: Using data from the longitudinal cohort of Hanzhong Adolescent Hypertension Study, 1,803 participants aged 6–18 years were enrolled and followed for 36 years (1987–2023). Cumulative BP burden was quantified as the area under the curve (AUC) for systolic BP (SBP) or diastolic BP (DBP) values exceeding prespecified thresholds. CKM stages were categorized as early (stages 0–2) and advanced (stages 3–4), based on the presence of cardiovascular disease, chronic kidney disease, and metabolic abnormalities. Multivariate logistic regression models were used to assess associations between cumulative BP load and CKM outcomes. Results: Over 36 years of follow-up, higher cumulative SBP load was associated with progressively increased risk of advanced CKM stages adjusted ORs: 1.60 (95% CI: 1.16–2.21), 2.10 (1.54–2.88), and 3.75 (2.77–5.09) for groups 1–3, respectively. Similar graded associations were observed for cumulative DBP load ORs: 2.83 (1.88–4.33), 3.17 (2.11–4.86), and 6.79 (4.54–10.41). Elevated cumulative BP load was also associated with left ventricular diastolic dysfunction, left ventricular hypertrophy, subclinical kidney damage, albuminuria, central obesity, diabetes, and hypertriglyceridemia. Similar results were observed for mean arterial pressure load. Conclusions: Higher life-course cumulative BP load is independently associated with increased risk of advanced CKM outcomes in midlife. These findings highlight the need for early-life interventions and sustained BP control to mitigate CKM burden risk later in life.
Wang et al. (2026) conducted a cohort in Cardiovascular-kidney-metabolic (CKM) syndrome (n=1,803). Cumulative blood pressure load vs. Lower cumulative blood pressure load was evaluated on Advanced CKM stages (stages 3-4) (OR 3.75, 95% CI 2.77-5.09). Higher cumulative systolic blood pressure load from childhood to midlife was associated with an increased risk of advanced cardiovascular-kidney-metabolic syndrome (OR 3.75; 95% CI 2.77-5.09).