Doctor Measures Blood Pressure In The Patient
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A population-based study from Sweden indicates that children and teenagers who were overweight or have obesity are more likely to have high blood pressure in later adult years from 50 to 64 years of age.

The research, to be presented at the upcoming European Congress on Obesity (ECO) next month showed a linear relationship with both higher BMI at eight years and greater BMI change during puberty (BMI at 20 years minus childhood BMI), independent of each other, in adult men. In women, middle age blood pressure increased in a linear fashion based on the level of BMI change during puberty unrelated to childhood.

“Our results suggest that preventing overweight and obesity beginning in childhood matters when it comes to achieving a healthy blood pressure in later life,” says lead author Lina Lilja, MD, from the University of Gothenburg in Sweden. “Children and teenagers living with overweight or obesity might benefit from targeted initiatives and lifestyle modifications to reduce the substantial disease burden associated with high blood pressure in later life from diseases such as heart attacks, strokes, and kidney damage.”

High BMI in adults is known to be associated with increased blood pressure and hypertension, but, to date, the relative contribution of elevated BMI to this condition in midlife from elevated BMI in childhood and during puberty remains unknown.

In their observational study, the Swedish investigators gathered data from two population-based datasets: the BMI Epidemiology Study (BEST) Gothenburg cohort and the Swedish CArdioPulmonary bioImage Study (SCAPIS). From these two sources, the team analyzed data from 1,683 people—858 men and 825 women—born between 1948 and 1968.

For people from the BEST cohort, the researchers measured the developmental BMI using school health records at the ages of seven and eight years old and also as young adults between the ages of 18 and 20 from school health records or enrollment in the military which was mandatory for young men until 2010. Midlife blood pressure data were derived from the SCAPIS study of participants who were not taking high blood pressure medication at the time their data was collected.

Analysis of participants that included both childhood BMI and BMI change through puberty showed that for men, an increase in one BMI unit (equivalent to an average pubertal BMI change of 5.4kg/m2) was associated with an increase in systolic blood pressure at middle age of 1.03 mmHG and a 0.53 mmHG increase in diastolic blood pressure independent of each other.

In women, a one BMI unit increase in pubertal BMI was associated with a 0.96 mmHg increase in systolic blood pressure and a 0.77 mmHg increase in diastolic blood pressure in middle age, irrespective of childhood BMI. In contrast, childhood BMI was not linked with systolic or diastolic blood pressure in midlife, irrespective of the pubertal BMI change.

While the increases noted in this research are not very large, Jenny Kindblom, MD, of Sahlgrenska University Hospital, noted that even small elevations in blood pressure experienced over many years can damage blood vessels and contribute to the development of cardiovascular and kidney diseases.

“Our findings indicate that high blood pressure may originate in early life,” Kindblom said. “Excessive fat mass induces chronic low-grade inflammation and endothelial dysfunction already in childhood. Higher amounts of visceral abdominal fat increases the risk of developing hypertension in adults. And we have previously shown that a large pubertal BMI change in men is associated with visceral obesity [fat around the internal organs] at a young adult age. So enlarged visceral fat mass might, in individuals with a high BMI increase during puberty, be a possible mechanism contributing to higher blood pressure.”

“This study is important given the rising tide of obesity among children and teens. It is vital that we turn the focus from high blood pressure in adults to include people in younger age groups,” she concluded.

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