Association Between Early Life Growth and Blood Pressure Trajectories in Black South African Children.
Early growth is associated with blood pressure measured on one occasion, but whether early life growth patterns are associated with longitudinal blood pressure trajectories is under-researched. Therefore, we sought to examine the association between early growth and blood pressure trajectories from childhood to adulthood. Blood pressure was measured on 7 occasions between ages 5 and 18 years in the Birth to Twenty cohort study, and conditional variables for growth in infancy and mid-childhood were computed from anthropometric measures (n=1937, 52% girls). We used a group-based trajectory modeling approach to identify distinct height-adjusted blood pressure trajectories and then tested their association with growth between birth and mid-childhood adjusting for several covariates. Three trajectory groups were identified for systolic and diastolic blood pressure: lower, middle, and upper in boys and girls, separately. In boys, predictors of the middle or upper systolic blood pressure trajectories versus the lower trajectory were in birth weight (odds ratio 0.75 [95% confidence interval 0.58-0.96] per SD) and relative weight gain in infancy (4.11 [1.25-13.51] per SD). In girls, greater relative weight gain and linear growth in both infancy and mid-childhood were consistently associated with an almost 2-fold higher likelihood of being in the upper versus lower systolic blood pressure trajectory. The associations for the diastolic blood pressure trajectories were inconsistent. These findings emphasize the importance of identifying children at risk of progression to high blood pressure. Accelerated growth in infancy and mid-childhood may be a key target for early life intervention in prevention of elevated blood pressure progression.
From the MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, University of the Witwatersrand, Johannesburg, South Africa (J.K., L.S.A., R.J.M., J.M.P., S.A.N.); and Department of Nutrition, University of North Carolina, Chapel Hill (L.S.A.). julianakagura@gmail.com.
Juliana
J
Kagura
From the MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, University of the Witwatersrand, Johannesburg, South Africa (J.K., L.S.A., R.J.M., J.M.P., S.A.N.); and Department of Nutrition, University of North Carolina, Chapel Hill (L.S.A.).
Linda S
LS
Adair
From the MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, University of the Witwatersrand, Johannesburg, South Africa (J.K., L.S.A., R.J.M., J.M.P., S.A.N.); and Department of Nutrition, University of North Carolina, Chapel Hill (L.S.A.).
Richard J
RJ
Munthali
From the MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, University of the Witwatersrand, Johannesburg, South Africa (J.K., L.S.A., R.J.M., J.M.P., S.A.N.); and Department of Nutrition, University of North Carolina, Chapel Hill (L.S.A.).
John M
JM
Pettifor
From the MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, University of the Witwatersrand, Johannesburg, South Africa (J.K., L.S.A., R.J.M., J.M.P., S.A.N.); and Department of Nutrition, University of North Carolina, Chapel Hill (L.S.A.).
Shane A
SA
Norris
D000293:Adolescent; D000886:Anthropometry; D044383:Black People; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination; D002648:Child; D002657:Child Development / Q000502:physiology*; D002675:Child, Preschool; D015331:Cohort Studies; D016001:Confidence Intervals; D016208:Databases, Factual; D005260:Female; D006801:Humans; D006973:Hypertension / Q000517:prevention & control*; D016015:Logistic Models; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods*; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D013019:South Africa
adolescence; blood pressure; childhood; growth; trajectories
Lancet. 2005 Jan 15-21;365(9455):217-23
15652604
Pediatrics. 1996 Oct;98(4 Pt 1):649-58
8885941
Acta Paediatr. 2010 Jan;99(1):24-9
19839954
Pediatrics. 2004 Aug;114(2 Suppl 4th Report):555-76
15286277
Epidemiology. 2012 Mar;23 (2):203-11
22249241
PLoS Med. 2011 Jun;8(6):e1000440
21695075
Acta Paediatr Suppl. 2006 Apr;450:76-85
16817681
Acta Physiol (Oxf). 2014 Feb;210(2):307-16
24268043
Am J Physiol Regul Integr Comp Physiol. 2007 Feb;292(2):R758-63
16917022
Circulation. 2002 Mar 5;105(9):1088-92
11877360
J Hum Hypertens. 1999 Jun;13(6):385-91
10408588
Hypertension. 2012 Apr;59(4):796-801
22331381
BMC Pediatr. 2015 Jul 15;15:78
26173634
Hypertension. 2003 Mar;41(3):451-6
12623942
Circulation. 2015 May 12;131(19):1674-81
25858196
BMC Proc. 2009 Dec 15;3 Suppl 7:S114
20017979
West Indian Med J. 2012 Oct;61(7):674-83
23620964
Physiol Rev. 2014 Oct;94(4):1027-76
25287859
J Clin Epidemiol. 2005 Dec;58(12):1320-4
16291478
Lancet. 2015 Dec 5;386(10010):2287-323
26364544
Hypertension. 2007 Oct;50(4):679-85
17724277
J Am Heart Assoc. 2015 Mar 09;4(3):e001378
25753924
Lancet. 2013 Aug 10;382(9891):525-34
23541370
J Hum Hypertens. 1990 Apr;4(2):103-4
2140133
Int J Epidemiol. 2007 Jun;36(3):504-11
17355979
J Hypertens. 2000 Jul;18(7):815-31
10930178
Pediatr Nephrol. 2013 Jul;28(7):1059-66
23138756
Ann Epidemiol. 2006 Jan;16(1):11-8
16039878
JAMA. 2014 Feb 5;311(5):490-7
24496536
Hypertension. 2015 Dec;66(6):1108-15
26558818
Arch Dis Child. 2000 May;82(5):358-63
10799423
Annu Rev Clin Psychol. 2010;6:109-38
20192788
Ann Hum Biol. 2014 Jan-Feb;41(1):91-3
23931557
Am J Epidemiol. 1977 Aug;106(2):101-8
888812