[Effect of blood pressure status changes from childhood to adulthood on hypertension related cardiac-renal function in adulthood].
OBJECTIVE
To assess the effect of blood pressure (BP) changes from childhood to adulthood on hypertension related cardiac and renal function in adulthood.


METHODS
The "Beijing children and adolescents BP study cohort" consists of 2505 subjects 6-18 years of age who were enrolled in the baseline BP investigation in 1987. Among them, 412 individuals aged 23-37 years were successfully followed up in 2005. In this study, clinical examinations and questionnaire survey about risk factors of cardiovascular disease (CVD) were carried out.


RESULTS
Among 412 adults, the prevalence rate of hypertension was 14.8% (61/412); 83.6% of persons with hypertension were overweight or had obesity. Hypertension related cardiac and renal functional abnormalities were relatively common (72.1%) clinical signs among this adult population. With BP level elevation, cardiac and renal functions damage became more severe. The morbidity of cardiac and renal functional abnormalities in those who were hypertensive in childhood and were not hypertensive in adulthood was similar to those who were not hypertensive at both times. The morbidity of microalbuminuria and abnormalities in electrocardiogram (ECG) were higher in those who were hypertensive at both times than those who had appropriate BP levels in childhood and became hypertensive in adulthood. Adjusted for age, gender, BMI and body surface area (BSA) during adulthood, the left ventricular end-diastolic dimension (LVd), the left ventricular mass (LVM), the intraventricular septal thickness (IVST), the left ventricular posterior wall thickness (LVPWT) in the group of hypertension were higher than that in the group which was not hypertensive, and the ejection fraction (EF) was lower in the group of hypertension in adulthood. The LVd, LVM, IVST, LVPWT and EF in those who were hypertensive in childhood and were not hypertensive in adulthood were similar to those who were not hypertensive at both times. Logistic regression analysis showed that persons who were hypertensive in childhood and remained so during adulthood were at an increased risk of cardiac and renal functional damage (OR = 4.072, 95% CI = 1.472 - 11.266). Those who were hypertensive in childhood and became normotensive in adulthood did not have significant abnormalities in cardiac and renal functions (OR = 1.086, 95% CI = 0.514 - 2.298, chi2 = 0.047, P = 0.828).


CONCLUSIONS
Persons who were hypertensive at both times were at an increased risk of cardiac and renal function damage. Those who were hypertensive in childhood and became normotensive in adulthood did not have significant abnormalities in cardiac and renal functions. Thus prevention and control of hypertension in children and adolescents may have important beneficial effects on prevention of CVD in adulthood.
Zhao
Di
D
Department of Internal Medicine, Children's Hospital Affiliated to the Capital Institute of Pediatrics, Beijing 100020, China.
Zhang
Ming-Ming
MM
Mi
Jie
J
Wang
Li
L
Liang
Lu
L
Hou
Dong-Qing
DQ
Wang
Tian-You
TY
D000293:Adolescent; D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D002648:Child; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000517:prevention & control*; D007677:Kidney Function Tests; D008297:Male; D055815:Young Adult