Published online February 1, 2007
PEDIATRICS Vol. 119 No. 2 February 2007, pp. 237-246 (doi:10.1542/peds.2006-2543)
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ARTICLE

Systolic Blood Pressure in Childhood Predicts Hypertension and Metabolic Syndrome Later in Life

Shumei S. Sun, PhDa, Gilman D. Grave, MDb, Roger M. Siervogel, PhDa, Arthur A. Pickoff, MDa,c, Silva S. Arslanian, MDd and Stephen R. Daniels, MDe

a Lifespan Health Research Center, Department of Community Health
c Department of Pediatrics, Wright State University Boonshoft School of Medicine, Dayton, Ohio
b National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
d Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
e Department of Pediatrics, University of Colorado, School of Medicine, Denver, Colorado

OBJECTIVE. The goal was to link hypertension and the metabolic syndrome in adulthood directly to blood pressures measured decades earlier for the same individuals as children and to establish criterion values for blood pressure that predict hypertension and the metabolic syndrome later in life.

METHODS. We analyzed serial data for 240 men and 253 women in the Fels Longitudinal Study. We derived age- and gender-specific childhood blood pressures that predict hypertension and the metabolic syndrome in adulthood, and we validated these criterion values in a larger sample.

RESULTS. Blood pressure diverged between adults with and without the metabolic syndrome beginning at age 5 for boys and age 8 for girls. The odds ratios for developing hypertension at ≥30 years of age ranged from 1.1 for 14- to 18-year-old boys to 3.8 for 5- to 7-year-old boys and from 2.7 for 8- to 13-year-old girls to 4.5 for 5- to 7-year-old girls, if their blood pressure exceeded criterion values at a single examination in childhood. The corresponding odds ratios for the metabolic syndrome, with or without hypertension, ranged from 1.2 for 14- to 18-year-old boys to 2.6 for 8- to 13-year-old boys and from 1.5 for 14- to 18-year-old girls to 3.1 for 5- to 7-year-old girls. The relative risk of adult hypertension ranged from 1.5 to 3.8 for boys and from 1.5 to 4.7 for girls, and that of the metabolic syndrome ranged from 1.1 to 1.8 for boys and from 1.2 to 5.6 for girls. These relative risks varied directly with the number of examinations at which systolic blood pressure exceeded criterion values.

CONCLUSION. Children with systolic blood pressures above the criterion values established in this longitudinal study are at increased risk of hypertension and the metabolic syndrome later in life.

Key Words: childhood blood pressure • adult hypertension • metabolic syndrome

Abbreviations: NCEP—National Cholesterol Education Program • ATP III—Adult Treatment Panel III • NHANES—National Health and Nutrition Examination Survey • EBP—elevated blood pressure • ROC—receiver operating characteristic • HDL—high-density lipoprotein

Accepted Oct 12, 2006.