2009 Southern Regional Meeting Abstracts

Purpose of Study: Increased blood pressure (BP) variability is associated with severity of end-organ damage and a higher rate of cardiovascular events. This study tested the hypothesis that childhood BP variability is associated with adulthood hypertension in adulthood.
Methods Used: The longitudinal study cohort consisted of 1797 adults (1091 whites and 706 blacks; 44.4% males; age=21-48 years,) enrolled in the Bogalusa Heart Study. Subjects were examined serially 4-8 times for BP during childhood (age range=4-19 years; mean age=13.1 years), with 9035 measurements of BP. Quadratic curves of childhood BP versus age were constructed. The childhood BP variability was measured as rate of change (variability I), residuals from age-predicted values (variability II) and residuals from the overall mean values (variability III).
Summary of Results: The overall prevalence of hypertension in adulthood was 14.1% (n=253), with blacks having a higher prevalence than whites (19.6% vs 10.5%, p<0.001). Blacks also showed significantly greater childhood BP variability I and III than whites for systolic BP. Odds ratios (OR) and 95% confidence intervals (CI) were estimated by multivariate logistic regression analyses, using adulthood hypertension status as a dependent variable, adjusting for covariates. As shown in the table below, hypertension in adulthood was significantly associated with measures of BP variability during childhood except for systolic BP variability II. Further, the childhood BP variability was a stronger predictor of adulthood hypertension than childhood BP levels, although the levels were also significantly associated with adulthood hypertension.
Conclusions: These findings by showing a stronger association between childhood BP variability and adulthood hypertension suggest that the response of BP to environmental factors during growth may play an important role in the development of hypertension.

Odds ratio of childhood BP variability measures for adulthood hypertension, adjusting for race, sex, adulthood age and BMI, childhood mean BP levels and BMI variability (* p<0.001)

	Systolic BP			Diastolic BP
	Variability I	Variability II	Variability III	Variability I	Variability II	Variability III
OR	1.16*	1.09	1.12*	1.18*	1.20*	1.19*
95% CI	1.10-1.24	0.99-1.20	1.06-1.19	1.08-1.30	1.10-1.31	1.11-1.28