title: Ambulatory blood pressure and its variability in adults born preterm.
abstract: Adults born preterm have higher blood pressure (BP) than those born at term. Most studies have focused on preterm birth, and few have assessed BP variability, an independent risk factor of cardiovascular disease. We studied the association of preterm birth with 24-hour ambulatory BP, measured by an oscillometric device, in 42 young adults born early preterm (<34 weeks), 72 born late preterm (34-36 weeks), and 103 controls (≥37 weeks). Sleep was confirmed with accelerometry in 72.4% of subjects. The 24-hour systolic BP of adults born early preterm was 5.5 mm Hg higher (95% confidence interval, 1.9-9.3), awake systolic BP was 6.4 mm Hg higher (95% confidence interval, 2.8-10.1), and sleeping systolic BP was 2.9 mm Hg higher (95% confidence interval 0.3-7.5) when adjusted for age, sex, and use of accelerometry. The differences remained similar when adjusted for height, body mass index, physical activity, smoking, parental education, maternal body mass index, smoking during pregnancy, and gestational diabetes mellitus and attenuated slightly when adjusted for maternal hypertensive pregnancy disorders. Adults born early preterm also had higher BP variability as indicated by higher individual standard deviations of systolic BP and diastolic BP. Although our results were consistent with a dose-response relationship between shorter gestation and higher BP, the difference between the late preterm and term groups was not statistically significant. Our results suggest that the higher BP in adults born early preterm is present during both waking and sleeping hours, may be more pronounced during waking hours, and is accompanied by higher individual BP variability.
authors.affiliation: From the Departments of Chronic Disease Prevention (M.S.-L., R.K., M.T., H.-M.M., P.H., J.G.E., E.K.) and Children and Families (M.-R.J., M.V.), National Institute for Health and Welfare, Oulu and Helsinki, Finland; Institute of Health Sciences (M.S.-L., M.T., M.-R.J.) and Department of Obstetrics and Gynecology, Medical Research Center Oulu, Oulu University Hospital (M.V., E.K.), University of Oulu, Oulu, Finland; Biocenter Oulu, Oulu, Finland (M.-R.J.); Department of Pediatrics and Adolescence, Oulu University Hospital, Oulu, Finland (M.S.-L.); Unit of Primary Care, Oulu, Finland (M.R.J.); Institute of Behavioural Sciences (S.M., A.-K.P., K.R.) and Children's Hospital, Helsinki University Central Hospital (P.H., E.K.), University of Helsinki, Helsinki, Finland; Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland (J.G.E.); Department of Epidemiology and Biostatistics, Imperial College London, MRC Health Protection Agency (HPA) Centre for Environment and Health, School of Public Health, London, United Kingdom (M.-R.J.); and Folkhälsan Research Center, Helsinki, Finland (J.G.E.). marika.sipola-leppanen@thl.fi.
authors.forename: Marika
authors.initials: M
authors.lastname: Sipola-Leppänen
authors.affiliation: From the Departments of Chronic Disease Prevention (M.S.-L., R.K., M.T., H.-M.M., P.H., J.G.E., E.K.) and Children and Families (M.-R.J., M.V.), National Institute for Health and Welfare, Oulu and Helsinki, Finland; Institute of Health Sciences (M.S.-L., M.T., M.-R.J.) and Department of Obstetrics and Gynecology, Medical Research Center Oulu, Oulu University Hospital (M.V., E.K.), University of Oulu, Oulu, Finland; Biocenter Oulu, Oulu, Finland (M.-R.J.); Department of Pediatrics and Adolescence, Oulu University Hospital, Oulu, Finland (M.S.-L.); Unit of Primary Care, Oulu, Finland (M.R.J.); Institute of Behavioural Sciences (S.M., A.-K.P., K.R.) and Children's Hospital, Helsinki University Central Hospital (P.H., E.K.), University of Helsinki, Helsinki, Finland; Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland (J.G.E.); Department of Epidemiology and Biostatistics, Imperial College London, MRC Health Protection Agency (HPA) Centre for Environment and Health, School of Public Health, London, United Kingdom (M.-R.J.); and Folkhälsan Research Center, Helsinki, Finland (J.G.E.).
authors.forename: Risto
authors.initials: R
authors.lastname: Karvonen
authors.affiliation: From the Departments of Chronic Disease Prevention (M.S.-L., R.K., M.T., H.-M.M., P.H., J.G.E., E.K.) and Children and Families (M.-R.J., M.V.), National Institute for Health and Welfare, Oulu and Helsinki, Finland; Institute of Health Sciences (M.S.-L., M.T., M.-R.J.) and Department of Obstetrics and Gynecology, Medical Research Center Oulu, Oulu University Hospital (M.V., E.K.), University of Oulu, Oulu, Finland; Biocenter Oulu, Oulu, Finland (M.-R.J.); Department of Pediatrics and Adolescence, Oulu University Hospital, Oulu, Finland (M.S.-L.); Unit of Primary Care, Oulu, Finland (M.R.J.); Institute of Behavioural Sciences (S.M., A.-K.P., K.R.) and Children's Hospital, Helsinki University Central Hospital (P.H., E.K.), University of Helsinki, Helsinki, Finland; Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland (J.G.E.); Department of Epidemiology and Biostatistics, Imperial College London, MRC Health Protection Agency (HPA) Centre for Environment and Health, School of Public Health, London, United Kingdom (M.-R.J.); and Folkhälsan Research Center, Helsinki, Finland (J.G.E.).
authors.forename: Marjaana
authors.initials: M
authors.lastname: Tikanmäki
authors.affiliation: From the Departments of Chronic Disease Prevention (M.S.-L., R.K., M.T., H.-M.M., P.H., J.G.E., E.K.) and Children and Families (M.-R.J., M.V.), National Institute for Health and Welfare, Oulu and Helsinki, Finland; Institute of Health Sciences (M.S.-L., M.T., M.-R.J.) and Department of Obstetrics and Gynecology, Medical Research Center Oulu, Oulu University Hospital (M.V., E.K.), University of Oulu, Oulu, Finland; Biocenter Oulu, Oulu, Finland (M.-R.J.); Department of Pediatrics and Adolescence, Oulu University Hospital, Oulu, Finland (M.S.-L.); Unit of Primary Care, Oulu, Finland (M.R.J.); Institute of Behavioural Sciences (S.M., A.-K.P., K.R.) and Children's Hospital, Helsinki University Central Hospital (P.H., E.K.), University of Helsinki, Helsinki, Finland; Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland (J.G.E.); Department of Epidemiology and Biostatistics, Imperial College London, MRC Health Protection Agency (HPA) Centre for Environment and Health, School of Public Health, London, United Kingdom (M.-R.J.); and Folkhälsan Research Center, Helsinki, Finland (J.G.E.).
authors.forename: Hanna-Maria
authors.initials: HM
authors.lastname: Matinolli
authors.affiliation: From the Departments of Chronic Disease Prevention (M.S.-L., R.K., M.T., H.-M.M., P.H., J.G.E., E.K.) and Children and Families (M.-R.J., M.V.), National Institute for Health and Welfare, Oulu and Helsinki, Finland; Institute of Health Sciences (M.S.-L., M.T., M.-R.J.) and Department of Obstetrics and Gynecology, Medical Research Center Oulu, Oulu University Hospital (M.V., E.K.), University of Oulu, Oulu, Finland; Biocenter Oulu, Oulu, Finland (M.-R.J.); Department of Pediatrics and Adolescence, Oulu University Hospital, Oulu, Finland (M.S.-L.); Unit of Primary Care, Oulu, Finland (M.R.J.); Institute of Behavioural Sciences (S.M., A.-K.P., K.R.) and Children's Hospital, Helsinki University Central Hospital (P.H., E.K.), University of Helsinki, Helsinki, Finland; Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland (J.G.E.); Department of Epidemiology and Biostatistics, Imperial College London, MRC Health Protection Agency (HPA) Centre for Environment and Health, School of Public Health, London, United Kingdom (M.-R.J.); and Folkhälsan Research Center, Helsinki, Finland (J.G.E.).
authors.forename: Silja
authors.initials: S
authors.lastname: Martikainen
authors.affiliation: From the Departments of Chronic Disease Prevention (M.S.-L., R.K., M.T., H.-M.M., P.H., J.G.E., E.K.) and Children and Families (M.-R.J., M.V.), National Institute for Health and Welfare, Oulu and Helsinki, Finland; Institute of Health Sciences (M.S.-L., M.T., M.-R.J.) and Department of Obstetrics and Gynecology, Medical Research Center Oulu, Oulu University Hospital (M.V., E.K.), University of Oulu, Oulu, Finland; Biocenter Oulu, Oulu, Finland (M.-R.J.); Department of Pediatrics and Adolescence, Oulu University Hospital, Oulu, Finland (M.S.-L.); Unit of Primary Care, Oulu, Finland (M.R.J.); Institute of Behavioural Sciences (S.M., A.-K.P., K.R.) and Children's Hospital, Helsinki University Central Hospital (P.H., E.K.), University of Helsinki, Helsinki, Finland; Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland (J.G.E.); Department of Epidemiology and Biostatistics, Imperial College London, MRC Health Protection Agency (HPA) Centre for Environment and Health, School of Public Health, London, United Kingdom (M.-R.J.); and Folkhälsan Research Center, Helsinki, Finland (J.G.E.).
authors.forename: Anu-Katriina
authors.initials: AK
authors.lastname: Pesonen
authors.affiliation: From the Departments of Chronic Disease Prevention (M.S.-L., R.K., M.T., H.-M.M., P.H., J.G.E., E.K.) and Children and Families (M.-R.J., M.V.), National Institute for Health and Welfare, Oulu and Helsinki, Finland; Institute of Health Sciences (M.S.-L., M.T., M.-R.J.) and Department of Obstetrics and Gynecology, Medical Research Center Oulu, Oulu University Hospital (M.V., E.K.), University of Oulu, Oulu, Finland; Biocenter Oulu, Oulu, Finland (M.-R.J.); Department of Pediatrics and Adolescence, Oulu University Hospital, Oulu, Finland (M.S.-L.); Unit of Primary Care, Oulu, Finland (M.R.J.); Institute of Behavioural Sciences (S.M., A.-K.P., K.R.) and Children's Hospital, Helsinki University Central Hospital (P.H., E.K.), University of Helsinki, Helsinki, Finland; Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland (J.G.E.); Department of Epidemiology and Biostatistics, Imperial College London, MRC Health Protection Agency (HPA) Centre for Environment and Health, School of Public Health, London, United Kingdom (M.-R.J.); and Folkhälsan Research Center, Helsinki, Finland (J.G.E.).
authors.forename: Katri
authors.initials: K
authors.lastname: Räikkönen
authors.affiliation: From the Departments of Chronic Disease Prevention (M.S.-L., R.K., M.T., H.-M.M., P.H., J.G.E., E.K.) and Children and Families (M.-R.J., M.V.), National Institute for Health and Welfare, Oulu and Helsinki, Finland; Institute of Health Sciences (M.S.-L., M.T., M.-R.J.) and Department of Obstetrics and Gynecology, Medical Research Center Oulu, Oulu University Hospital (M.V., E.K.), University of Oulu, Oulu, Finland; Biocenter Oulu, Oulu, Finland (M.-R.J.); Department of Pediatrics and Adolescence, Oulu University Hospital, Oulu, Finland (M.S.-L.); Unit of Primary Care, Oulu, Finland (M.R.J.); Institute of Behavioural Sciences (S.M., A.-K.P., K.R.) and Children's Hospital, Helsinki University Central Hospital (P.H., E.K.), University of Helsinki, Helsinki, Finland; Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland (J.G.E.); Department of Epidemiology and Biostatistics, Imperial College London, MRC Health Protection Agency (HPA) Centre for Environment and Health, School of Public Health, London, United Kingdom (M.-R.J.); and Folkhälsan Research Center, Helsinki, Finland (J.G.E.).
authors.forename: Marjo-Riitta
authors.initials: MR
authors.lastname: Järvelin
authors.affiliation: From the Departments of Chronic Disease Prevention (M.S.-L., R.K., M.T., H.-M.M., P.H., J.G.E., E.K.) and Children and Families (M.-R.J., M.V.), National Institute for Health and Welfare, Oulu and Helsinki, Finland; Institute of Health Sciences (M.S.-L., M.T., M.-R.J.) and Department of Obstetrics and Gynecology, Medical Research Center Oulu, Oulu University Hospital (M.V., E.K.), University of Oulu, Oulu, Finland; Biocenter Oulu, Oulu, Finland (M.-R.J.); Department of Pediatrics and Adolescence, Oulu University Hospital, Oulu, Finland (M.S.-L.); Unit of Primary Care, Oulu, Finland (M.R.J.); Institute of Behavioural Sciences (S.M., A.-K.P., K.R.) and Children's Hospital, Helsinki University Central Hospital (P.H., E.K.), University of Helsinki, Helsinki, Finland; Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland (J.G.E.); Department of Epidemiology and Biostatistics, Imperial College London, MRC Health Protection Agency (HPA) Centre for Environment and Health, School of Public Health, London, United Kingdom (M.-R.J.); and Folkhälsan Research Center, Helsinki, Finland (J.G.E.).
authors.forename: Petteri
authors.initials: P
authors.lastname: Hovi
authors.affiliation: From the Departments of Chronic Disease Prevention (M.S.-L., R.K., M.T., H.-M.M., P.H., J.G.E., E.K.) and Children and Families (M.-R.J., M.V.), National Institute for Health and Welfare, Oulu and Helsinki, Finland; Institute of Health Sciences (M.S.-L., M.T., M.-R.J.) and Department of Obstetrics and Gynecology, Medical Research Center Oulu, Oulu University Hospital (M.V., E.K.), University of Oulu, Oulu, Finland; Biocenter Oulu, Oulu, Finland (M.-R.J.); Department of Pediatrics and Adolescence, Oulu University Hospital, Oulu, Finland (M.S.-L.); Unit of Primary Care, Oulu, Finland (M.R.J.); Institute of Behavioural Sciences (S.M., A.-K.P., K.R.) and Children's Hospital, Helsinki University Central Hospital (P.H., E.K.), University of Helsinki, Helsinki, Finland; Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland (J.G.E.); Department of Epidemiology and Biostatistics, Imperial College London, MRC Health Protection Agency (HPA) Centre for Environment and Health, School of Public Health, London, United Kingdom (M.-R.J.); and Folkhälsan Research Center, Helsinki, Finland (J.G.E.).
authors.forename: Johan G
authors.initials: JG
authors.lastname: Eriksson
authors.affiliation: From the Departments of Chronic Disease Prevention (M.S.-L., R.K., M.T., H.-M.M., P.H., J.G.E., E.K.) and Children and Families (M.-R.J., M.V.), National Institute for Health and Welfare, Oulu and Helsinki, Finland; Institute of Health Sciences (M.S.-L., M.T., M.-R.J.) and Department of Obstetrics and Gynecology, Medical Research Center Oulu, Oulu University Hospital (M.V., E.K.), University of Oulu, Oulu, Finland; Biocenter Oulu, Oulu, Finland (M.-R.J.); Department of Pediatrics and Adolescence, Oulu University Hospital, Oulu, Finland (M.S.-L.); Unit of Primary Care, Oulu, Finland (M.R.J.); Institute of Behavioural Sciences (S.M., A.-K.P., K.R.) and Children's Hospital, Helsinki University Central Hospital (P.H., E.K.), University of Helsinki, Helsinki, Finland; Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland (J.G.E.); Department of Epidemiology and Biostatistics, Imperial College London, MRC Health Protection Agency (HPA) Centre for Environment and Health, School of Public Health, London, United Kingdom (M.-R.J.); and Folkhälsan Research Center, Helsinki, Finland (J.G.E.).
authors.forename: Marja
authors.initials: M
authors.lastname: Vääräsmäki
authors.affiliation: From the Departments of Chronic Disease Prevention (M.S.-L., R.K., M.T., H.-M.M., P.H., J.G.E., E.K.) and Children and Families (M.-R.J., M.V.), National Institute for Health and Welfare, Oulu and Helsinki, Finland; Institute of Health Sciences (M.S.-L., M.T., M.-R.J.) and Department of Obstetrics and Gynecology, Medical Research Center Oulu, Oulu University Hospital (M.V., E.K.), University of Oulu, Oulu, Finland; Biocenter Oulu, Oulu, Finland (M.-R.J.); Department of Pediatrics and Adolescence, Oulu University Hospital, Oulu, Finland (M.S.-L.); Unit of Primary Care, Oulu, Finland (M.R.J.); Institute of Behavioural Sciences (S.M., A.-K.P., K.R.) and Children's Hospital, Helsinki University Central Hospital (P.H., E.K.), University of Helsinki, Helsinki, Finland; Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland (J.G.E.); Department of Epidemiology and Biostatistics, Imperial College London, MRC Health Protection Agency (HPA) Centre for Environment and Health, School of Public Health, London, United Kingdom (M.-R.J.); and Folkhälsan Research Center, Helsinki, Finland (J.G.E.).
authors.forename: Eero
authors.initials: E
authors.lastname: Kajantie
mesh_terms: D000328:Adult; D032721:Adult Children; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D002318:Cardiovascular Diseases / Q000453:epidemiology; D016022:Case-Control Studies; D002940:Circadian Rhythm / Q000502:physiology; D005260:Female; D005865:Gestational Age; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D047928:Premature Birth / Q000503:physiopathology*; D015995:Prevalence; D012307:Risk Factors
keywords: blood pressure monitoring, ambulatory; gestational age; hypertension; premature birth