Blood pressure change and subclinical target organ damage in mid-adulthood
T S Guo, D Wang, Y Yan, G L Hu, J MuAbstract
Background
Blood pressure (BP) is a dynamic trait associated with cardiovascular disease.
Purpose
We aimed to estimate age-specific BP levels and rates of change from childhood to mid-adulthood and examine their associations with subsequent subclinical target organ damage.
Methods
We included 2,508 participants from the Hanzhong Adolescent Hypertension Study with BP measured ≥ 4 times from 1987 to 2023. Subclinical target organ damage included arterial stiffness, left ventricular hypertrophy (LVH), and albuminuria.
Results
The rates of change in BP across childhood to mid-adulthood were positively associated with arterial stiffness and albuminuria in mid-adulthood, independent of corresponding BP levels. The magnitude of associations rose from childhood, peaked in adolescence, and declined thereafter. For example, odds ratios (ORs) (95% confidence intervals [CIs]) per one standard deviation increase in systolic BP change rates for arterial stiffness increased from 1.94 (1.69-2.24) at age 6 to 2.11 (1.82-2.44) at age 13, then declined to 1.13 (1.01-1.28) by age 52. Faster BP increases were more strongly associated with arterial stiffness and albuminuria than concurrent BP levels during childhood and adolescence, whereas the opposite trend was observed in young and mid-adulthood. Similar age-dependent trends were identified for LVH, with minor variations in the age at which associations reached statistical significance.
Conclusions
Faster BP increases during childhood and adolescence, particularly in adolescence, show a stronger association with mid-adult subclinical target organ damage than increases occurring in adulthood, suggesting that this period may be sensitive for optimizing BP trajectories to mitigate long-term cardiovascular and kidney risks.For image description, please refer to the figure legend and surrounding text.For image description, please refer to the figure legend and surrounding text.