title: Adipose and height growth through childhood and blood pressure status in a large prospective cohort study.
abstract: Raised blood pressure (BP) is the world's leading mortality risk factor. Childhood BP substantially predicts adult levels, and although both prenatal and postnatal growth influence it, their relative importance is debated. In a longitudinal study (Avon Longitudinal Study of Parents and Children) of 12 962 healthy children, we aimed to assess the relative contribution of different growth periods and of standardized measures of height versus weight-for-height (an adiposity marker) to BP at age 10 years. Conditional growth modeling was used in the 3230 boys and 3346 girls with BP measurements. Systolic BP was inversely associated with birth weight and weight-for-height but not length (-0.33, -0.27, and -0.12 mm Hg · SD(-1); P=0.003, 0.035, and 0.35, respectively). In infancy, weight, weight-for-height, and height gains were all positively associated with systolic BP (0.90, 0.41, and 0.82 mm Hg · SD(-1), respectively; all P<0.001). After infancy, all of the growth modalities were positively associated with systolic BP (weight, 1.91; weight-for-height, 1.56; height, 1.20 mm Hg · SD(-1); all P<0.001). Similar but weaker associations were found with diastolic BP. Although BP at 10 years was associated with both prenatal and early postnatal growth, their influence was small compared with that of later growth. Because BP ranking relative to the population is substantially determined in the first decade of life, a focus on strategies to reduce the development of adiposity from infancy onward, rather than an emphasis on the nutrition and weight of mothers and infants, should bring greater reductions in population BP.
authors.affiliation: Vascular Physiology Unit, University College London Institute of Cardiovascular Science, London, UK. alex.jones@ucl.ac.uk
authors.forename: Alexander
authors.initials: A
authors.lastname: Jones
authors.forename: Marietta
authors.initials: M
authors.lastname: Charakida
authors.forename: Emanuela
authors.initials: E
authors.lastname: Falaschetti
authors.forename: Aroon D
authors.initials: AD
authors.lastname: Hingorani
authors.forename: Nicholas
authors.initials: N
authors.lastname: Finer
authors.forename: Stefano
authors.initials: S
authors.lastname: Masi
authors.forename: Ann E
authors.initials: AE
authors.lastname: Donald
authors.forename: Debbie A
authors.initials: DA
authors.lastname: Lawlor
authors.forename: George Davey
authors.initials: GD
authors.lastname: Smith
authors.forename: John E
authors.initials: JE
authors.lastname: Deanfield
mesh_terms: D050154:Adiposity / Q000502:physiology; D017677:Age Distribution; D001724:Birth Weight; D001795:Blood Pressure Determination; D001827:Body Height; D001835:Body Weight; D002648:Child; D002657:Child Development / Q000502:physiology*; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000503:physiopathology; D007223:Infant; D007231:Infant, Newborn; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D009765:Obesity / Q000453:epidemiology* / Q000503:physiopathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D017678:Sex Distribution; D006113:United Kingdom