To identify systolic blood pressure (SBP) percentile trajectories in children and to describe the early-life risk factors and cardiometabolic correlates of those trajectories.
Using age-, sex-, and height-specific SBP percentiles based on the American Academy of Pediatrics reference, we examined SBP trajectories using latent class mixed models from ages 3 to 8 years (n=844) from the GUSTO-study, a Singaporean mother-offspring cohort study. We analyzed associations between SBP trajectories and early-life risk factors using multinomial logistic regression and differences across trajectories in cardiometabolic outcomes using multiple linear regression.
Children were classified into one of four SBP percentile trajectories: “low increasing” (15%), “high stable” (47%), “high decreasing” (20%), “low stable” (18%). Maternal hypertension during early pregnancy was a predictor of the “high stable” and “low increasing” SBP trajectories. Rapid child weight gain in the first two years of life was only associated with the “high stable” trajectory. Compared with children in the “low stable” trajectory, children in the “high stable” SBP trajectory had higher BMI z-scores, sum of skinfold thicknesses, waist circumference from ages 3 to 8 years and abdominal adipose tissue (mL) at 4.5 years (adjusted mean difference [95%CI]: superficial and deep subcutaneous abdominal adipose tissue: 115.2[48.1,182.3] and 85.5[35.2,135.8]). Their fat mass (kg) (1.3[0.6,2.0]), triglyceride levels (mmol/L) (0.10[0.02,0.18]), HOMA1-IR (0.28[0.11,0.46]) at age 6 years were also higher but not their arterial thickness and stiffness.
Reducing maternal BP during pregnancy and infant weight gain in the first two years of life might help to prevent the development of high SBP.

Copyright © 2021. Published by Elsevier Inc.