Abstract
Hypertension is a pivotal factor in cardiovascular risk. However, the association of longitudinal blood pressure (BP) trajectories in the early life and cardiovascular risk assessed by target organ damage (TOD) in adulthood is poorly reported. The objective of this study was to identify the association between systolic BP, diastolic BP, and mean atrial pressure (MAP) trajectories early in life with a single or multiple TOD in later life. We identified BP trajectories from 6 to 45 year-old using group-based trajectory models among 2430 individuals in the Hanzhong Adolescent Hypertension Study and examined the relationship between BP trajectories and cardiovascular risk in later life. Four discrete long-term systolic BP, diastolic BP, and MAP trajectories were identified, namely, low stable, moderate stable, high stable (low increasing), and moderate increasing groups, based on the BP levels at baseline and in the 30-year follow-up. The carotid intima-media thickness were higher in persistently high or increasing trajectories in comparison to the low stable group. Individuals with deteriorative trajectories during early life were at an increased risk of suffering from a single TOD, including left ventricular hypertrophy (LVH) and carotid atherosclerosis (CA) in middle age (36–49 years old). Moreover, higher BP trajectories were correlated with the presence of combined TODs load stage which were assessed by CA, LVH, arteriosclerosis and subclinical renal damage (SRD). Higher longitudinal BP trajectories early in life were associated with increased cardiovascular risk in midlife, and identifying BP trajectories in early life can help screen individuals with TOD later.
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Funding
This work was supported by grants 81870319 (J-JM), 81570381 (J-JM), 82200472 (W-LZ) and 81700368 (CC) from the National Natural Science Foundation of China, grant 2017YFC1307604 from the Major Chronic Non-communicable Disease Prevention and Control Research Key Project of the Ministry of Science and Technology of the People’s Republic of China, grant 2017ZDXM-SF-107 from the Key Research Project of Shaanxi Province, and grant XJTU1AF-CRF-2019-004 from the Clinical Research Award of the First Affiliated Hospital of Xi’an Jiaotong University. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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Zheng, W., Mu, J., Yan, Y. et al. Associations of blood pressure trajectories in early life with target organ damage in midlife : a 30-year cohort study. Hypertens Res 46, 2613–2621 (2023). https://doi.org/10.1038/s41440-023-01387-8
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DOI: https://doi.org/10.1038/s41440-023-01387-8
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