Childhood physical, environmental, and genetic predictors of adult hypertension: the cardiovascular risk in young Finns study.
BACKGROUND
Hypertension is a major modifiable cardiovascular risk factor. The present longitudinal study aimed to examine the best combination of childhood physical and environmental factors to predict adult hypertension and furthermore whether newly identified genetic variants for blood pressure increase the prediction of adult hypertension.


RESULTS
The study cohort included 2625 individuals from the Cardiovascular Risk in Young Finns Study who were followed up for 21 to 27 years since baseline (1980; age, 3-18 years). In addition to dietary factors and biomarkers related to blood pressure, we examined whether a genetic risk score based on 29 newly identified single-nucleotide polymorphisms enhances the prediction of adult hypertension. Hypertension in adulthood was defined as systolic blood pressure ≥ 130 mm Hg and/or diastolic blood pressure ≥ 85 mm Hg or medication for the condition. Independent childhood risk factors for adult hypertension included the individual's own blood pressure (P<0.0001), parental hypertension (P<0.0001), childhood overweight/obesity (P=0.005), low parental occupational status (P=0.003), and high genetic risk score (P<0.0001). Risk assessment based on childhood overweight/obesity status, parental hypertension, and parental occupational status was superior in predicting hypertension compared with the approach using only data on childhood blood pressure levels (C statistics, 0.718 versus 0.733; P=0.0007). Inclusion of both parental hypertension history and data on novel genetic variants for hypertension further improved the C statistics (0.742; P=0.015).


CONCLUSIONS
Prediction of adult hypertension was enhanced by taking into account known physical and environmental childhood risk factors, family history of hypertension, and novel genetic variants. A multifactorial approach may be useful in identifying children at high risk for adult hypertension.
Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Kiinamyllynkatu 10, FI-20520 Turku, Finland. jopasi@utu.fi
Jonna
J
Juhola
Mervi
M
Oikonen
Costan G
CG
Magnussen
Vera
V
Mikkilä
Niina
N
Siitonen
Eero
E
Jokinen
Tomi
T
Laitinen
Peter
P
Würtz
Samuel S
SS
Gidding
Leena
L
Taittonen
Ilkka
I
Seppälä
Antti
A
Jula
Mika
M
Kähönen
Nina
N
Hutri-Kähönen
Terho
T
Lehtimäki
Jorma S A
JS
Viikari
Markus
M
Juonala
Olli T
OT
Raitakari
D000328:Adult; D000367:Age Factors; D001794:Blood Pressure / Q000235:genetics*; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000208:ethnology* / Q000209:etiology; D015331:Cohort Studies; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000208:ethnology* / Q000209:etiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000208:ethnology / Q000235:genetics; D050177:Overweight / Q000150:complications / Q000208:ethnology / Q000235:genetics; D010375:Pedigree; D020641:Polymorphism, Single Nucleotide / Q000235:genetics*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012923:Social Class