Introduction: In the last years, the prevalence of high blood pressure (HBP) has increased in children, contributing to raise the risk of future cardiovascular disease. It is known that family history, pregnancy characteristics and type of feeding in the first months of life are of great importance in the prevention of diseases in the offspring. In this study we aimed to investigate the association between early life risk factors and HBP in children and adolescents.
Materials and methods: A total of 794 children between 5 and 18 years were recruited (53.3% girls, 49.7% prepubertal, 42.9% with overweight/obesity). Blood pressure (BP) was measured and information regarding early life risk factors was collected with a parental questionnaire. HBP was considered when systolic BP≥P90 (Task Force 1996). Associations between HBP and early life risk factors were analyzed with a binary logistic regression adjusted for age, sex and body mass index. All analyses were conducted with SPSS 21.0.
Results: Children whose parents had a history of HBP had an increased risk of HBP themselves (OR=2.031, 95% confidence interval (CI) 1.422−2.900, P<0.001). In addition, children whose mothers had gestational diabetes or pregnancy-induced hypertension showed an increased HBP risk than those born to mothers with healthy pregnancies (OR=2.057, 95% CI 1.214−3.483, P=0.007; OR=3.102, 95% CI 1.911−5.037, P<0.001; respectively). HBP risk also increased in premature children (30−37 weeks) (OR=2.262, 95% CI 1.299−3.938, P=0.004), children born by C-section (OR=2.133, 95% CI 0.766−5.943) or children who had an early start of complementary feeding (<4 months) (OR=2.832, 95% CI 1.526−5.258, P=0.001). No statistically significant associations were observed between birth weight or exclusive breastfeeding and childhood HBP.
Conclusion: Parental history of HBP, pregnancy complications, premature or C-section delivery and an early complementary feeding introduction before 4 months increase the risk of HBP in children and adolescents independently of BMI. Adequate mechanisms should be established in order to avoid modifiable risk factors and to prevent further health alterations in children already at risk.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology