Childhood blood pressure (BP) is a strong predictor for later cardiovascular risk. However, few studies have assessed dynamic BP trajectories throughout the early life period. We investigated the relationship between early life factors and systolic BP (SBP) from infancy to adolescence using linear spline mixed-effect models among 1370 children from Project Viva, a Boston-area cohort recruited in 1999‒2002. After adjusting for confounders and child height, we observed higher SBP in children exposed to gestational diabetes [vs. normoglycemia‒at 3 years: β 3.16mmHg (95% confidence interval 0.28,6.04); 6 years: 1.83mmHg (0.06,3.60)], hypertensive disorders of pregnancy [vs. normal maternal BP‒at 6 years: 1.39mmHg (0.10,2.67); 9 years: 1.84mmHg (0.34,3.34); 12 years: 1.70mmHg (0.48,2.92)], higher neonatal SBP [per 10mmHg increase‒at 3 years: 1.26mmHg (0.42,2.09); 6 years: 1.00mmHg (0.49,1.51); 9 years: 0.75mmHg (0.17,1.33)] and formula milk in the first 6 months [vs. breastmilk only‒at 12 years: 2.10mmHg (0.46,3.74); 15 years: 3.52mmHg (1.40,5.64); 18 years: 4.94mmHg (1.88,7.99)]. Our findings provide evidence of programming of offspring SBP trajectories by gestational diabetes, hypertensive disorders of pregnancy and formula milk intake, and of neonatal BP being a potentially useful marker of childhood BP. These factors could be relevant in identifying children who are at risk of developing elevated BP.
Am. J. Epidemiol.
Early Life Predictors of Systolic Blood Pressure Trajectories from Infancy to Adolescence: Findings from Project Viva.