Meta-analysis of blood pressure tracking from childhood to adulthood and implications for the design of intervention trials.
OBJECTIVE
Blood pressure (BP) is related with cardiovascular disease. BP tracking in childhood and its implication for intervention trials are unknown.


METHODS
A systematic review and meta-analysis were conducted to estimate BP tracking.


RESULTS
In 29 independent studies on 27,820 subjects, follow-up length and baseline age were associated with systolic BP tracking (both p < 0.05), while gender, BP measurement method and study place were not (p = 0.215, p = 0.185 and p = 0.391). The overall adjusted systolic BP correlation coefficient was 0.44 between 10 and 11 years and decreased to 0.37 between 10 and 20 years. Comparison of BP changes before and after intervention need a 26% increased sample size for a 10-year follow-up of 10 year olds, while trials comparing BP values at study end only require smaller sample sizes.


CONCLUSIONS
Blood pressure tracking from childhood to adulthood affects trials assessing long-term effects on BP and was low-to-moderate. Therefore, regular BP controls are also needed in children with normal BP measurements possibly identifying hypertensive children earlier. A slight short-term intervention effect on BP may not have any long-term effects because of low BP tracking and its decrease by age.
Department of Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilians University of Munich, Munich, Germany. michael.toschke@ibe.med.uni-muenchen.de
A M
AM
Toschke
L
L
Kohl
U
U
Mansmann
R
R
von Kries
D000293:Adolescent; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination; D002648:Child; D002986:Clinical Trials as Topic / Q000379:methods*; D006801:Humans; D006973:Hypertension / Q000517:prevention & control*; D012044:Regression Analysis; D012107:Research Design; D055815:Young Adult