Long-Term Blood Pressure Exposure From Childhood and Early Vascular Aging in Midlife: A 30-Year Prospective Cohort Study

Early vascular aging (EVA) increases cardiovascular mortality, but its long-term determinants are unknown. We included 2098 participants with ≥4 blood pressure (BP) measurements from childhood to adulthood (from the Hanzhong Adolescent Hypertension Cohort study) to investigate the impact of child-to-adult cumulative BP exposure on EVA patterns in midlife. Participants with EVA had significantly higher long-term BP burden than those with normal vascular age in midlife despite being much younger. Child-to-adult cumulative burden and trends of systolic and diastolic BP were associated with vascular age (standardized regression coefficient [β] = .31 to .53; P < .001 for all). Higher cumulative systolic and diastolic BP exposure significantly increased the risk of EVA in midlife (odds ratio, OR=1.67 to 2.75, P < .05 for all). All associations were independent of socio-demographics and cardiovascular risk factors. Excluding participants who were receiving anti-hypertensive, antidiabetic, or lipid-lowering treatments did not substantially change the above associations. This study, for the first time, reported that high cumulative child-to-adult BP exposure accelerated the vascular aging process. Stabilizing BP across life course could be beneficial to vascular health in the long run.

[1]  J. Mu,et al.  Sex differences in impact of long-term burden and trends of body mass index and blood pressure from childhood to adulthood on arterial stiffness in adults: A 30-year cohort study. , 2020, Atherosclerosis.

[2]  Jiang He,et al.  Impact of Long‐Term Burden of Body Mass Index and Blood Pressure From Childhood on Adult Left Ventricular Structure and Function , 2020, Journal of the American Heart Association.

[3]  J. Mu,et al.  The predictive value of repeated blood pressure measurements in childhood for cardiovascular risk in adults: the Hanzhong Adolescent Hypertension Study , 2020, Hypertension Research.

[4]  S. Rubattu,et al.  Vascular ageing in hypertension: Focus on mitochondria , 2020, Mechanisms of Ageing and Development.

[5]  J. Mu,et al.  Body Mass Index Trajectories in Early Life Is Predictive of Cardiometabolic Risk. , 2020, The Journal of pediatrics.

[6]  P. Nilsson.  Early Vascular Aging in Hypertension , 2020, Frontiers in Cardiovascular Medicine.

[7]  Jiang He,et al.  Life-Course Cumulative Burden of Body Mass Index and Blood Pressure on Progression of Left Ventricular Mass and Geometry in Midlife , 2020, Circulation research.

[8]  Farzaneh A. Sorond,et al.  Cumulative Blood Pressure Exposure During Young Adulthood and Mobility and Cognitive Function in Midlife , 2019, Circulation.

[9]  R. Townsend,et al.  Large-Artery Stiffness in Health and Disease: JACC State-of-the-Art Review. , 2019, Journal of the American College of Cardiology.

[10]  P. Nilsson,et al.  Concept of Extremes in Vascular Aging. , 2019, Hypertension.

[11]  Jiang He,et al.  Long-Term Burden of Higher Body Mass Index and Adult Arterial Stiffness Are Linked Predominantly Through Elevated Blood Pressure , 2019, Hypertension.

[12]  Ernst Rietzschel,et al.  Characteristics of healthy vascular ageing in pooled population-based cohort studies: the global Metabolic syndrome and Artery REsearch Consortium , 2018, Journal of hypertension.

[13]  J. Mu,et al.  Association of Blood Pressure Trajectories in Early Life with Subclinical Renal Damage in Middle Age. , 2018, Journal of the American Society of Nephrology : JASN.

[14]  Jackson T. Wright,et al.  2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. , 2018, Journal of the American Society of Hypertension : JASH.

[15]  E. Benjamin,et al.  Prevalence, Correlates, and Prognosis of Healthy Vascular Aging in a Western Community-Dwelling Cohort: The Framingham Heart Study , 2017, Hypertension.

[16]  K. Kario,et al.  Brachial-Ankle Pulse Wave Velocity and the Risk Prediction of Cardiovascular Disease: An Individual Participant Data Meta-Analysis , 2017, Hypertension.

[17]  J. Mu,et al.  Associations of risk factors in childhood with arterial stiffness 26 years later: the Hanzhong adolescent hypertension cohort , 2017, Journal of hypertension.

[18]  S. Laurent,et al.  Elevated estimated arterial age is associated with metabolic syndrome and low-grade inflammation , 2016, Journal of hypertension.

[19]  P. López-Jaramillo,et al.  A call to action and a lifecourse strategy to address the global burden of raised blood pressure on current and future generations: the Lancet Commission on hypertension , 2016, The Lancet.

[20]  S. Norris,et al.  Association Between Early Life Growth and Blood Pressure Trajectories in Black South African Children , 2016, Hypertension.

[21]  A. Hofman,et al.  Mid- to Late-Life Trajectories of Blood Pressure and the Risk of Stroke: The Rotterdam Study , 2016, Hypertension.

[22]  S. Peters,et al.  Vascular age to determine cardiovascular disease risk: A systematic review of its concepts, definitions, and clinical applications , 2016, European journal of preventive cardiology.

[23]  R. Webb,et al.  Toll-like Receptors in the Vascular System: Sensing the Dangers Within , 2016, Pharmacological Reviews.

[24]  Mark Woodward,et al.  Usual blood pressure, peripheral arterial disease, and vascular risk: cohort study of 4.2 million adults , 2015, BMJ : British Medical Journal.

[25]  S. Laurent,et al.  The structural factor of hypertension: large and small artery alterations. , 2015, Circulation research.

[26]  A. Danser,et al.  Hypertension Renin–Angiotensin–Aldosterone System Alterations , 2015 .

[27]  D. Harrison,et al.  Inflammation, immunity, and hypertensive end-organ damage. , 2015, Circulation research.

[28]  Guido Grassi,et al.  The sympathetic nervous system alterations in human hypertension. , 2015, Circulation research.

[29]  M. Soto,et al.  Aging in blood vessels. Medicinal agents FOR systemic arterial hypertension in the elderly , 2014, Ageing Research Reviews.

[30]  S. Srinivasan,et al.  Impact of long-term burden of excessive adiposity and elevated blood pressure from childhood on adulthood left ventricular remodeling patterns: the Bogalusa Heart Study. , 2014, Journal of the American College of Cardiology.

[31]  Ken Aho,et al.  Model selection for ecologists: the worldviews of AIC and BIC. , 2014, Ecology.

[32]  L. Ferrucci,et al.  Longitudinal Trajectories of Arterial Stiffness and the Role of Blood Pressure: The Baltimore Longitudinal Study of Aging , 2013, Hypertension.

[33]  J. Mu,et al.  Evolution of blood pressure from adolescents to youth in salt sensitivies: a 18-year follow-up study in Hanzhong children cohort , 2012, Nutrition Journal.

[34]  Yutaka Imai,et al.  European Society of Hypertension International Protocol revision 2010 for the validation of blood pressure measuring devices in adults , 2010, Blood pressure monitoring.

[35]  Stéphane Laurent,et al.  Vascular aging: A tale of EVA and ADAM in cardiovascular risk assessment and prevention. , 2009, Hypertension.

[36]  P. Nilsson,et al.  The early life origins of vascular ageing and cardiovascular risk: the EVA syndrome , 2008, Journal of hypertension.

[37]  P. Nilsson.  Early vascular aging (EVA): consequences and prevention , 2008, Vascular health and risk management.

[38]  M. O'Rourke,et al.  Mechanical factors in arterial aging: a clinical perspective. , 2007, Journal of the American College of Cardiology.

[39]  Daniel W. Jones,et al.  Recommendations for blood pressure measurement in humans and experimental animals: Part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research. , 2005, Hypertension.

[40]  P. Whelton,et al.  Hypertension , 1942, Nature Reviews Disease Primers.