This article is more than 5 years old. Information may no longer be current.
Systolic BP in childhood predicts risk for future metabolic syndrome
Readings that exceed age- and gender-specific blood pressure criteria should be a warning sign.
Click Here to Manage Email Alerts
Blood pressure may help to predict metabolic syndrome in children as young as 5.
New research in Pediatrics highlights a direct relationship between childhood blood pressure readings and hypertension and metabolic syndrome in adulthood.
In a comparison of childhood blood pressure readings in adults with metabolic syndrome and without metabolic syndrome, blood pressure readings began to diverge at age 5 for boys and age 8 for girls.
“The current recommendation from the National Heart, Lung, and Blood Institute is for blood pressure to be measured routinely after age 3,” said Stephen R. Daniels, MD, PhD, professor and chairman in the department of pediatrics at the University of Colorado School of Medicine. “This probably does not happen as much as it should in primary care offices.”
Daniels and colleagues conducted a two-part study to determine the earliest age of divergence of blood pressure in adults with metabolic syndrome. First, the researchers conducted a retrospective cohort study of 125 people within the Fels Longitudinal Study population that were classified by the National Cholesterol Education Program Adult Treatment Panel III criteria as having metabolic syndrome. The blood pressure readings from these people were compared to 138 age- and gender-matched people without metabolic syndrome.
Second, the researchers determined age- and gender-specific blood pressure levels that predict hypertension and metabolic syndrome in adults and validated these levels in a larger sample.
Systolic blood pressure
Data adjusted for birth weight and bone age indicated that the earliest significant difference in blood pressure values between adults with and without metabolic syndrome occurred at age 5 for boys and age 8 for girls (P<.05).
Although there were no significant differences in diastolic blood pressure readings, both men and women with metabolic syndrome had significantly higher systolic blood pressure readings during their childhood.
Birth weight did not have a significant effect on childhood blood pressure, but advanced bone age was associated with a 1.9 mm Hg per year increase in systolic blood pressure for boys and a 1.5 mm Hg per year increase in systolic blood pressure for girls. Girls also had a 1.3 mm Hg increase per year in diastolic blood pressure related to advanced bone age.
For boys aged 5 to 12 and girls aged 5 to 18 who had a mean systolic blood pressure reading at any examination that exceeded the age- and gender-specific blood pressure criterion, the risk for developing hypertension at age 30 or older was three to four times greater than boys and girls whose blood pressures were within normal ranges.
If these increased blood pressures levels recurred, boys aged 5 to 18 and girls aged 8 to 18 had a significantly greater chance of developing hypertension compared to boys and girls who only had one reading that exceeded age- and gender-specific criteria.
Metabolic syndrome
Children who had multiple blood pressure readings above age- and gender-specific criteria were also at increased risk for developing metabolic syndrome by age 30 or older. This risk was greatest for boys aged 13 to 18 and girls aged 8 to 12.
Having even one blood pressure reading above age- and gender-specific criteria significantly increased the chance of getting metabolic syndrome in boys aged 8 to 12 and girls aged 5 to 12.
“Primary care physicians should be measuring blood pressure on a regular basis, interpreting those blood pressures correctly, and when high blood pressure is identified, then appropriate clinical treatment should be implemented,” Daniels said, noting that he considered the best approach to this was outlined in the 4th Report of the National High Blood Pressure Education Program, which was also published in Pediatrics. –by Leah Lawrence
For more information:
- Sun SS, Grave GD, Siervogel RM, et al. Systolic blood pressure in childhood predicts hypertension and metabolic syndrome later in life. Pediatrics. 2007;119:237-246.
- National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004;114:555-576.