title: Repeated Blood Pressure Measurements in Childhood in Prediction of Hypertension in Adulthood.
abstract: Hypertension may be predicted from childhood risk factors. Repeated observations of abnormal blood pressure in childhood may enhance prediction of hypertension and subclinical atherosclerosis in adulthood compared with a single observation. Participants (1927, 54% women) from the Cardiovascular Risk in Young Finns Study had systolic and diastolic blood pressure measurements performed when aged 3 to 24 years. Childhood/youth abnormal blood pressure was defined as above 90th or 95th percentile. After a 21- to 31-year follow-up, at the age of 30 to 45 years, hypertension (>140/90 mm Hg or antihypertensive medication) prevalence was found to be 19%. Carotid intima-media thickness was examined, and high-risk intima-media was defined as intima-media thickness >90th percentile or carotid plaques. Prediction of adulthood hypertension and high-risk intima-media was compared between one observation of abnormal blood pressure in childhood/youth and multiple observations by improved Pearson correlation coefficients and area under the receiver operating curve. When compared with a single measurement, 2 childhood/youth observations improved the correlation for adult systolic (r=0.44 versus 0.35, P<0.001) and diastolic (r=0.35 versus 0.17, P<0.001) blood pressure. In addition, 2 abnormal childhood/youth blood pressure observations increased the prediction of hypertension in adulthood (0.63 for 2 versus 0.60 for 1 observation, P=0.003). When compared with 2 measurements, third observation did not provide any significant improvement for correlation or prediction (P always >0.05). A higher number of childhood/youth observations of abnormal blood pressure did not enhance prediction of adult high-risk intima-media thickness. Compared with a single measurement, the prediction of adult hypertension was enhanced by 2 observations of abnormal blood pressure in childhood/youth.
authors.affiliation: From Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (M.O., J.N., C.G.M., O.T.R.); Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia (C.G.M.); Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland (J.S.A.V., M.J.); Department of Pediatrics, Vaasa Central Hospital, Vaasa, Finland (L.T.); Department of Pediatrics, University of Oulu, Oulu, Finland (L.T.); Department of Clinical Physiology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland (T.L.); Department of Pediatrics, University of Tampere and Tampere University Hospital, Tampere, Finland (N.H.-K.); Department of Pediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland (E.J.); Department of Chronic Disease Prevention, National Institute for Health and Welfare, Turku, Finland (A.J.); Cardiology Department (M.C.) and Department of Endocrinology and Diabetes (M.A.S.), Murdoch Children's Research Institute, Royal Children's Hospital and University of Melbourne, Melbourne, Victoria, Australia; Department of Pediatrics, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora (S.R.D.); and Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland (O.T.R.). mervi.oikonen@utu.fi.
authors.forename: Mervi
authors.initials: M
authors.lastname: Oikonen
authors.affiliation: From Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (M.O., J.N., C.G.M., O.T.R.); Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia (C.G.M.); Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland (J.S.A.V., M.J.); Department of Pediatrics, Vaasa Central Hospital, Vaasa, Finland (L.T.); Department of Pediatrics, University of Oulu, Oulu, Finland (L.T.); Department of Clinical Physiology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland (T.L.); Department of Pediatrics, University of Tampere and Tampere University Hospital, Tampere, Finland (N.H.-K.); Department of Pediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland (E.J.); Department of Chronic Disease Prevention, National Institute for Health and Welfare, Turku, Finland (A.J.); Cardiology Department (M.C.) and Department of Endocrinology and Diabetes (M.A.S.), Murdoch Children's Research Institute, Royal Children's Hospital and University of Melbourne, Melbourne, Victoria, Australia; Department of Pediatrics, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora (S.R.D.); and Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland (O.T.R.).
authors.forename: Joel
authors.initials: J
authors.lastname: Nuotio
authors.affiliation: From Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (M.O., J.N., C.G.M., O.T.R.); Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia (C.G.M.); Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland (J.S.A.V., M.J.); Department of Pediatrics, Vaasa Central Hospital, Vaasa, Finland (L.T.); Department of Pediatrics, University of Oulu, Oulu, Finland (L.T.); Department of Clinical Physiology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland (T.L.); Department of Pediatrics, University of Tampere and Tampere University Hospital, Tampere, Finland (N.H.-K.); Department of Pediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland (E.J.); Department of Chronic Disease Prevention, National Institute for Health and Welfare, Turku, Finland (A.J.); Cardiology Department (M.C.) and Department of Endocrinology and Diabetes (M.A.S.), Murdoch Children's Research Institute, Royal Children's Hospital and University of Melbourne, Melbourne, Victoria, Australia; Department of Pediatrics, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora (S.R.D.); and Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland (O.T.R.).
authors.forename: Costan G
authors.initials: CG
authors.lastname: Magnussen
authors.affiliation: From Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (M.O., J.N., C.G.M., O.T.R.); Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia (C.G.M.); Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland (J.S.A.V., M.J.); Department of Pediatrics, Vaasa Central Hospital, Vaasa, Finland (L.T.); Department of Pediatrics, University of Oulu, Oulu, Finland (L.T.); Department of Clinical Physiology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland (T.L.); Department of Pediatrics, University of Tampere and Tampere University Hospital, Tampere, Finland (N.H.-K.); Department of Pediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland (E.J.); Department of Chronic Disease Prevention, National Institute for Health and Welfare, Turku, Finland (A.J.); Cardiology Department (M.C.) and Department of Endocrinology and Diabetes (M.A.S.), Murdoch Children's Research Institute, Royal Children's Hospital and University of Melbourne, Melbourne, Victoria, Australia; Department of Pediatrics, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora (S.R.D.); and Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland (O.T.R.).
authors.forename: Jorma S A
authors.initials: JS
authors.lastname: Viikari
authors.affiliation: From Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (M.O., J.N., C.G.M., O.T.R.); Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia (C.G.M.); Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland (J.S.A.V., M.J.); Department of Pediatrics, Vaasa Central Hospital, Vaasa, Finland (L.T.); Department of Pediatrics, University of Oulu, Oulu, Finland (L.T.); Department of Clinical Physiology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland (T.L.); Department of Pediatrics, University of Tampere and Tampere University Hospital, Tampere, Finland (N.H.-K.); Department of Pediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland (E.J.); Department of Chronic Disease Prevention, National Institute for Health and Welfare, Turku, Finland (A.J.); Cardiology Department (M.C.) and Department of Endocrinology and Diabetes (M.A.S.), Murdoch Children's Research Institute, Royal Children's Hospital and University of Melbourne, Melbourne, Victoria, Australia; Department of Pediatrics, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora (S.R.D.); and Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland (O.T.R.).
authors.forename: Leena
authors.initials: L
authors.lastname: Taittonen
authors.affiliation: From Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (M.O., J.N., C.G.M., O.T.R.); Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia (C.G.M.); Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland (J.S.A.V., M.J.); Department of Pediatrics, Vaasa Central Hospital, Vaasa, Finland (L.T.); Department of Pediatrics, University of Oulu, Oulu, Finland (L.T.); Department of Clinical Physiology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland (T.L.); Department of Pediatrics, University of Tampere and Tampere University Hospital, Tampere, Finland (N.H.-K.); Department of Pediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland (E.J.); Department of Chronic Disease Prevention, National Institute for Health and Welfare, Turku, Finland (A.J.); Cardiology Department (M.C.) and Department of Endocrinology and Diabetes (M.A.S.), Murdoch Children's Research Institute, Royal Children's Hospital and University of Melbourne, Melbourne, Victoria, Australia; Department of Pediatrics, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora (S.R.D.); and Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland (O.T.R.).
authors.forename: Tomi
authors.initials: T
authors.lastname: Laitinen
authors.affiliation: From Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (M.O., J.N., C.G.M., O.T.R.); Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia (C.G.M.); Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland (J.S.A.V., M.J.); Department of Pediatrics, Vaasa Central Hospital, Vaasa, Finland (L.T.); Department of Pediatrics, University of Oulu, Oulu, Finland (L.T.); Department of Clinical Physiology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland (T.L.); Department of Pediatrics, University of Tampere and Tampere University Hospital, Tampere, Finland (N.H.-K.); Department of Pediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland (E.J.); Department of Chronic Disease Prevention, National Institute for Health and Welfare, Turku, Finland (A.J.); Cardiology Department (M.C.) and Department of Endocrinology and Diabetes (M.A.S.), Murdoch Children's Research Institute, Royal Children's Hospital and University of Melbourne, Melbourne, Victoria, Australia; Department of Pediatrics, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora (S.R.D.); and Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland (O.T.R.).
authors.forename: Nina
authors.initials: N
authors.lastname: Hutri-Kähönen
authors.affiliation: From Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (M.O., J.N., C.G.M., O.T.R.); Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia (C.G.M.); Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland (J.S.A.V., M.J.); Department of Pediatrics, Vaasa Central Hospital, Vaasa, Finland (L.T.); Department of Pediatrics, University of Oulu, Oulu, Finland (L.T.); Department of Clinical Physiology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland (T.L.); Department of Pediatrics, University of Tampere and Tampere University Hospital, Tampere, Finland (N.H.-K.); Department of Pediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland (E.J.); Department of Chronic Disease Prevention, National Institute for Health and Welfare, Turku, Finland (A.J.); Cardiology Department (M.C.) and Department of Endocrinology and Diabetes (M.A.S.), Murdoch Children's Research Institute, Royal Children's Hospital and University of Melbourne, Melbourne, Victoria, Australia; Department of Pediatrics, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora (S.R.D.); and Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland (O.T.R.).
authors.forename: Eero
authors.initials: E
authors.lastname: Jokinen
authors.affiliation: From Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (M.O., J.N., C.G.M., O.T.R.); Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia (C.G.M.); Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland (J.S.A.V., M.J.); Department of Pediatrics, Vaasa Central Hospital, Vaasa, Finland (L.T.); Department of Pediatrics, University of Oulu, Oulu, Finland (L.T.); Department of Clinical Physiology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland (T.L.); Department of Pediatrics, University of Tampere and Tampere University Hospital, Tampere, Finland (N.H.-K.); Department of Pediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland (E.J.); Department of Chronic Disease Prevention, National Institute for Health and Welfare, Turku, Finland (A.J.); Cardiology Department (M.C.) and Department of Endocrinology and Diabetes (M.A.S.), Murdoch Children's Research Institute, Royal Children's Hospital and University of Melbourne, Melbourne, Victoria, Australia; Department of Pediatrics, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora (S.R.D.); and Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland (O.T.R.).
authors.forename: Antti
authors.initials: A
authors.lastname: Jula
authors.affiliation: From Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (M.O., J.N., C.G.M., O.T.R.); Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia (C.G.M.); Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland (J.S.A.V., M.J.); Department of Pediatrics, Vaasa Central Hospital, Vaasa, Finland (L.T.); Department of Pediatrics, University of Oulu, Oulu, Finland (L.T.); Department of Clinical Physiology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland (T.L.); Department of Pediatrics, University of Tampere and Tampere University Hospital, Tampere, Finland (N.H.-K.); Department of Pediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland (E.J.); Department of Chronic Disease Prevention, National Institute for Health and Welfare, Turku, Finland (A.J.); Cardiology Department (M.C.) and Department of Endocrinology and Diabetes (M.A.S.), Murdoch Children's Research Institute, Royal Children's Hospital and University of Melbourne, Melbourne, Victoria, Australia; Department of Pediatrics, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora (S.R.D.); and Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland (O.T.R.).
authors.forename: Michael
authors.initials: M
authors.lastname: Cheung
authors.affiliation: From Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (M.O., J.N., C.G.M., O.T.R.); Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia (C.G.M.); Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland (J.S.A.V., M.J.); Department of Pediatrics, Vaasa Central Hospital, Vaasa, Finland (L.T.); Department of Pediatrics, University of Oulu, Oulu, Finland (L.T.); Department of Clinical Physiology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland (T.L.); Department of Pediatrics, University of Tampere and Tampere University Hospital, Tampere, Finland (N.H.-K.); Department of Pediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland (E.J.); Department of Chronic Disease Prevention, National Institute for Health and Welfare, Turku, Finland (A.J.); Cardiology Department (M.C.) and Department of Endocrinology and Diabetes (M.A.S.), Murdoch Children's Research Institute, Royal Children's Hospital and University of Melbourne, Melbourne, Victoria, Australia; Department of Pediatrics, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora (S.R.D.); and Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland (O.T.R.).
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Sabin
authors.affiliation: From Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (M.O., J.N., C.G.M., O.T.R.); Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia (C.G.M.); Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland (J.S.A.V., M.J.); Department of Pediatrics, Vaasa Central Hospital, Vaasa, Finland (L.T.); Department of Pediatrics, University of Oulu, Oulu, Finland (L.T.); Department of Clinical Physiology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland (T.L.); Department of Pediatrics, University of Tampere and Tampere University Hospital, Tampere, Finland (N.H.-K.); Department of Pediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland (E.J.); Department of Chronic Disease Prevention, National Institute for Health and Welfare, Turku, Finland (A.J.); Cardiology Department (M.C.) and Department of Endocrinology and Diabetes (M.A.S.), Murdoch Children's Research Institute, Royal Children's Hospital and University of Melbourne, Melbourne, Victoria, Australia; Department of Pediatrics, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora (S.R.D.); and Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland (O.T.R.).
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Daniels
authors.affiliation: From Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (M.O., J.N., C.G.M., O.T.R.); Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia (C.G.M.); Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland (J.S.A.V., M.J.); Department of Pediatrics, Vaasa Central Hospital, Vaasa, Finland (L.T.); Department of Pediatrics, University of Oulu, Oulu, Finland (L.T.); Department of Clinical Physiology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland (T.L.); Department of Pediatrics, University of Tampere and Tampere University Hospital, Tampere, Finland (N.H.-K.); Department of Pediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland (E.J.); Department of Chronic Disease Prevention, National Institute for Health and Welfare, Turku, Finland (A.J.); Cardiology Department (M.C.) and Department of Endocrinology and Diabetes (M.A.S.), Murdoch Children's Research Institute, Royal Children's Hospital and University of Melbourne, Melbourne, Victoria, Australia; Department of Pediatrics, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora (S.R.D.); and Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland (O.T.R.).
authors.forename: Olli T
authors.initials: OT
authors.lastname: Raitakari
authors.affiliation: From Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (M.O., J.N., C.G.M., O.T.R.); Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia (C.G.M.); Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland (J.S.A.V., M.J.); Department of Pediatrics, Vaasa Central Hospital, Vaasa, Finland (L.T.); Department of Pediatrics, University of Oulu, Oulu, Finland (L.T.); Department of Clinical Physiology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland (T.L.); Department of Pediatrics, University of Tampere and Tampere University Hospital, Tampere, Finland (N.H.-K.); Department of Pediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland (E.J.); Department of Chronic Disease Prevention, National Institute for Health and Welfare, Turku, Finland (A.J.); Cardiology Department (M.C.) and Department of Endocrinology and Diabetes (M.A.S.), Murdoch Children's Research Institute, Royal Children's Hospital and University of Melbourne, Melbourne, Victoria, Australia; Department of Pediatrics, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora (S.R.D.); and Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland (O.T.R.).
authors.forename: Markus
authors.initials: M
authors.lastname: Juonala
mesh_terms: D000293:Adolescent; D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination / Q000379:methods*; D002339:Carotid Arteries / Q000000981:diagnostic imaging* / Q000503:physiopathology; D059168:Carotid Intima-Media Thickness; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000503:physiopathology*; D008297:Male; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D055815:Young Adult
keywords: atherosclerosis; blood pressure; follow-up studies; hypertension; risk factors