Blood Pressure at Different Life Stages Over the Early Life Course and Intima-Media Thickness

Yaxing Meng, James E Sharman, Juhani S Koskinen, Markus Juonala, Jorma S A Viikari, Marie-Jeanne Buscot, Feitong Wu, Brooklyn J Fraser, Suvi P Rovio, Mika Kähönen, Tapani Rönnemaa, Antti Jula, Harri Niinikoski, Olli T Raitakari, Katja Pahkala, Costan G Magnussen

Research output: Contribution to journalArticleScientificpeer-review

5 Citations (Scopus)
3 Downloads (Pure)

Abstract

IMPORTANCE: Although cardiovascular disease (CVD) begins in early life, the extent to which blood pressure (BP) at different life stages contributes to CVD is unclear.

OBJECTIVE: To determine the relative contribution of BP at different life stages across the early-life course from infancy to young adulthood with carotid intima-media thickness (IMT).

DESIGN, SETTING, AND PARTICIPANTS: The analyses were performed in 2022 using data gathered from July 1989 through January 2018 within the Special Turku Coronary Risk Factor Intervention Project, a randomized, infancy-onset cohort of 534 participants coupled with annual BP (from age 7 months to 20 years), biennial IMT measurements (from ages 13 to 19 years), who were followed up with again at age 26 years.

EXPOSURES: BP measured from infancy (aged 7 to 13 months), preschool (2 to 5 years), childhood (6 to 12 years), adolescence (13 to 17 years), and young adulthood (18 to 26 years).

MAIN OUTCOMES AND MEASURES: Primary outcomes were carotid IMT measured in young adulthood at age 26 years. Bayesian relevant life-course exposure models assessed the relative contribution of BP at each life stage.

RESULTS: Systolic BP at each life stage contributed to the association with young adulthood carotid IMT (infancy: relative weight, 25.3%; 95% credible interval [CrI], 3.6-45.8; preschool childhood: relative weight, 27.0%; 95% CrI, 3.3-57.1; childhood: relative weight, 18.0%; 95% CrI, 0.5-40.0; adolescence: relative weight, 13.5%; 95% CrI, 0.4-37.1; and young adulthood: relative weight, 16.2%; 95% CrI, 1.6-46.1). A 1-SD (at single life-stage) higher systolic BP accumulated across the life course was associated with a higher carotid IMT (0.02 mm; 95% CrI, 0.01-0.03). The findings for carotid IMT were replicated in the Cardiovascular Risk in Young Finns Study that assessed systolic BP from childhood and carotid IMT in adulthood (33 to 45 years).

CONCLUSION AND RELEVANCE: In this cohort study, a life-course approach indicated that accumulation of risk exposure to BP levels at all life stages contributed to adulthood carotid IMT. Of those, the contribution attributed to each observed life stage was approximately equal. These results support prevention efforts that achieve and maintain normal BP levels across the life course, starting in infancy.

Original languageEnglish
Pages (from-to)133-141
Number of pages9
JournalJAMA PEDIATRICS
Volume178
Issue number2
Early online date4 Dec 2023
DOIs
Publication statusPublished - 5 Feb 2024
Publication typeA1 Journal article-refereed

Publication forum classification

  • Publication forum level 3

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Public Health, Environmental and Occupational Health
  • Cardiology and Cardiovascular Medicine

Fingerprint

Dive into the research topics of 'Blood Pressure at Different Life Stages Over the Early Life Course and Intima-Media Thickness'. Together they form a unique fingerprint.

Cite this