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Children with elevated blood pressure in childhood can experience a greater risk of early death from cardiovascular disease (CVD) in adulthood, a new long-term study in JAMA finds. At baseline, 21% of the 37,081 children studied were classified as having hypertension, while about 19% were classified as having elevated blood pressure. Participants (born from 1959 to 1966) were followed to a median age of 54 years. At follow-up, a 1-SD higher systolic blood pressure measure at age 7 years was significantly associated with premature CVD mortality (adjusted hazard ratio [aHR] 1.14, 95% confidence interval [CI] 1.03-1.26). Likewise, a 1-SD higher diastolic blood pressure (aHR 1.18, 95% CI 1.07-1.29) also showed significant association with mortality. Elevated blood pressure (aHR 1.48, 95% CI 1.18-1.86) and hypertension (aHR 1.40, 95% CI 1.12-1.76) at age 7 years were both associated with a greater risk of CVD mortality. In the study period, data showed 487 cardiovascular deaths and 2,242 noncardiovascular deaths among participants.
Guidelines available: The American Academy of Pediatrics offers a clinical practice guideline for screening and management of high blood pressure in children and adolescents, published in Pediatrics in 2017, which is free to access on the publication website. The Academy notes that there has been an increase in the prevalence of high blood pressure in children with boys more likely to have high readings.