Researchers suggest that high blood pressure throughout infancy, childhood, and adolescence may contribute to thickening of the arteries in adulthood.
While the American Heart Association and the National Heart, Lung, and Blood Institute recommend routine blood pressure screening starting at age three, the U.S. Preventive Services Task Force (USPSTF) has a differing opinion. They believe that current evidence to support screening children and teens aged three to 18 years is not adequate to determine if the benefits for this age group outweigh the potential harms.
However, in a new study published on December 4 in JAMA Pediatrics, scientists found evidence that blood pressure screening before age three may help identify the risk of cardiovascular disease in adulthood.
Using 1989 to 2018 data from 534 participants in the Special Turku Coronary Risk Factor Intervention Project, a randomized, infancy-onset cohort, the scientists examined associations between systolic blood pressure readings at a young age and arterial thickness measurements at age 26.
The investigators looked at blood pressure measurements throughout infancy, preschool, childhood, adolescence, and young adulthood. The team also measured the participants' carotid intima-media thickness (IMT) — a surrogate marker for atherosclerotic cardiovascular disease (CVD).
They found that each 10 mmHg increase in systolic blood pressure in any early life stage was associated with a 0.02 mm increase in carotid IMT in young adulthood.
The authors note that another study investigating childhood systolic blood pressure and adult carotid IMT produced similar findings.
Still, none of the participants experienced a heart-related event during the follow-up period, so the researchers used carotid IMT as an indicator of artery injury and future cardiovascular disease risk. In addition, most of the participants were of white European descent, which means the results might not generalize to all people.
Nonetheless, the scientists say there may be potential benefits to routine blood pressure screenings in youngsters under three years of age.
"These findings suggest blood pressure prevention or intervention initiated later in life might be insufficient to reduce the associated risk that has accumulated earlier in life," the authors wrote.
What's considered high blood pressure in children?
According to the American Heart Association (AHA), for children 12 years and younger, blood pressure readings that fall into the ≥95th percentile for age, sex, and height on three or more occasions indicate high blood pressure or hypertension. This means that if the child is in the 95th percentile, they have a blood pressure reading higher than 95% of their peers.
For teens over the age of 12, guidelines define high blood pressure as 130/80 or higher.
The AHA estimates that up to 5% of children in the U.S. have high blood pressure not caused by an underlying health condition, and this often leads to hypertension in adulthood.
- U.S. Preventive Services Task Force. High Blood Pressure in Children and Adolescents: Screening.
- JAMA Pediatrics. Blood Pressure at Different Life Stages Over the Early Life Course and Intima-Media Thickness.
- American Heart Association. Maintaining healthy blood pressure in children is important for long-term health.
- American Heart Association. Children with high blood pressure often become adults with high blood pressure.