title: Simplified definitions of elevated pediatric blood pressure and high adult arterial stiffness.
abstract: OBJECTIVE
  The ability of childhood elevated blood pressure (BP) to predict high pulse wave velocity (PWV), a surrogate marker for cardiovascular disease, in adulthood has not been reported. We studied whether elevated pediatric BP could predict high PWV in adulthood and if there is a difference in the predictive ability between the standard BP definition endorsed by the National High Blood Pressure Education Program and the recently proposed 2 simplified definitions.
  
  
  METHODS
  The sample comprised 1241 subjects from the Cardiovascular Risk in Young Finns Study followed-up 27 years since baseline (1980, aged 6-15 years). Arterial PWV was measured in 2007 by whole-body impedance cardiography.
  
  
  RESULTS
  The relative risk for high PWV was 1.5 using the simple 1 (age-specific) definition, 1.6 using the simple 2 (age- and gender-specific) definition, and 1.7 using the complex (age-, gender-, and height-specific) definition (95% confidence interval: 1.1-2.0, P = .007; 1.2-2.2, P = .001; and 1.2-2.2, P = .001, respectively). Predictions of high PWV were equivalent for the simple 1 or simple 2 versus complex definition (P = .25 and P = .68 for area under the curve comparisons, P = .13 and P = .35 for net reclassification indexes, respectively).
  
  
  CONCLUSIONS
  Our results support the previous finding that elevated BP tracks from childhood to adulthood and accelerates the atherosclerotic process. The simplified BP tables could be used to identify pediatric patients at increased risk of high arterial stiffness in adulthood and hence to improve the primary prevention of cardiovascular diseases.
authors.affiliation: Department of Clinical Physiology, University of Tampere and Tampere University Hospital, Tampere, Finland.
authors.forename: Heikki
authors.initials: H
authors.lastname: Aatola
authors.forename: Costan G
authors.initials: CG
authors.lastname: Magnussen
authors.forename: Teemu
authors.initials: T
authors.lastname: Koivistoinen
authors.forename: Nina
authors.initials: N
authors.lastname: Hutri-Kähönen
authors.forename: Markus
authors.initials: M
authors.lastname: Juonala
authors.forename: Jorma S A
authors.initials: JS
authors.lastname: Viikari
authors.forename: Terho
authors.initials: T
authors.lastname: Lehtimäki
authors.forename: Olli T
authors.initials: OT
authors.lastname: Raitakari
authors.forename: Mika
authors.initials: M
authors.lastname: Kähönen
mesh_terms: D000293:Adolescent; D000328:Adult; D050197:Atherosclerosis / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D015415:Biomarkers; D001794:Blood Pressure / Q000502:physiology*; D002307:Cardiography, Impedance; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D005387:Finland; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D008137:Longitudinal Studies; D008297:Male; D063177:Pulse Wave Analysis; D012306:Risk; D013223:Statistics as Topic; D059289:Vascular Stiffness / Q000502:physiology*; D055815:Young Adult
chemical_list: D015415:Biomarkers
keywords: blood pressure; pediatrics; prehypertension; screening; stiffness