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  • Population Study Article
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Associations of central precocious puberty with blood pressure trajectories: prospective cohort study

Pediatric Research volume 95, pages 1147–1152 (2024)Cite this article

Abstract

Background

Sex differences in blood pressure (BP) appear during childhood and adolescence, but the role of central precocious puberty (CPP) remains unclear. In this study, we aimed to examine the association of CPP with the risk of early hypertension and BP trajectories in girls and boys.

Methods

We analyzed trajectories of BP before and after puberty in girls aged 6–13 years (n = 305) and boys aged 10–15 years (n = 153) in the Taiwan Pubertal Longitudinal Study. The timing of puberty onset was defined as the month at which the children reached Tanner stage 2. We examined the association of CPP with the risk of early hypertension and BP trajectories before and after puberty onset.

Results

Among boys, CPP was found to be associated with early hypertension (odds ratio, 7.45 [95% CI, 1.15–48.06]), whereas no such association was observed among girls. Boys with CPP had higher systolic BP than did those with normal puberty onset before puberty onset (mean difference, 6.51 [95% CI, 0.58–12.43]) and after puberty onset (mean difference, 8.92 [95% CI, 8.58–15.26]).

Conclusion

A large proportion of the higher systolic BP observed in boys with CPP compared with in those with normal puberty onset is accrued after puberty.

Impact

  • We examined the sex-specific association of central precocious puberty with blood pressure trajectories to better understand whether central precocious puberty was associated with early hypertension.

  • Central precocious puberty was associated with differences in systolic blood pressure trajectories, especially after puberty onset in boys. For boys only, central precocious puberty was associated with early hypertension.

  • A large proportion of the higher systolic blood pressure observed in boys with central precocious puberty compared with in those with normal puberty onset was accrued after puberty. Interventions targeting central precocious puberty are likely to influence systolic blood pressure in early adulthood.

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Fig. 1: Mean trajectories of systolic blood pressure (SBP) in children before and after Tanner Stage 2.
Fig. 2: Mean trajectories of diastolic blood pressure (DBP) in children before and after Tanner Stage 2.

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Data availability

Data are managed by the Taiwan Pubertal Longitudinal Study (TPLS). We analyzed the restricted-use TPLS dataset that are only available by application to the TPLS Data Access Center.

References

  1. Shen, W. et al. Race and sex differences of long-term blood pressure profiles from childhood and adult hypertension: the Bogalusa Heart Study. Hypertension 70, 66–74 (2017).

    Article  CAS  PubMed  Google Scholar 

  2. Wills, A. K. et al. Life course trajectories of systolic blood pressure using longitudinal data from eight Uk cohorts. PLoS Med. 8, e1000440 (2011).

    Article  PubMed  PubMed Central  Google Scholar 

  3. O’Keeffe, L. M. et al. Sex-specific trajectories of measures of cardiovascular health during childhood and adolescence: a prospective cohort study. Atherosclerosis 278, 190–196 (2018).

    Article  PubMed  Google Scholar 

  4. Dasgupta, K. et al. Emergence of sex differences in prevalence of high systolic blood pressure: analysis of a longitudinal adolescent cohort. Circulation 114, 2663–2670 (2006).

    Article  PubMed  Google Scholar 

  5. O’Keeffe, L. M. et al. Data on trajectories of measures of cardiovascular health in the Avon Longitudinal Study of parents and children (Alspac). Data Brief 23, 103687 (2019).

    Article  PubMed  PubMed Central  Google Scholar 

  6. Ji, H. et al. Sex differences in blood pressure trajectories over the life course. JAMA Cardiol. 5, 19–26 (2020).

    Article  PubMed  PubMed Central  Google Scholar 

  7. Gerdts, E. et al. Sex differences in arterial hypertension: a scientific statement from the Esc Council on Hypertension, the European Association of Preventive Cardiology, Association of Cardiovascular Nursing and Allied Professions, the Esc Council for Cardiology Practice, and the Esc Working Group on cardiovascular pharmacotherapy. Eur. Heart J. 43, 4777–4788 (2022).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Colafella, K. M. M. & Denton, K. M. Sex-specific differences in hypertension and associated cardiovascular disease. Nat. Rev. Nephrol. 14, 185–201 (2018).

    Article  PubMed  Google Scholar 

  9. Reckelhoff, J. F. Gender differences in the regulation of blood pressure. Hypertension 37, 1199–1208 (2001).

    Article  CAS  PubMed  Google Scholar 

  10. Li, Y. et al. Association between pubertal development and elevated blood pressure in children. J. Clin. Hypertens. 23, 1498–1505 (2021).

    Article  Google Scholar 

  11. Hulanicka, B., Lipowicz, A., Kozieł, S. & Kowalisko, A. Relationship between early puberty and the risk of hypertension/overweight at age 50: evidence for a modified Barker hypothesis among Polish youth. Econ. Hum. Biol. 5, 48–60 (2007).

    Article  PubMed  Google Scholar 

  12. Bubach, S. et al. Early menarche and blood pressure in adulthood: systematic review and meta-analysis. J. Public Health 40, 476–484 (2017).

    Article  Google Scholar 

  13. O’Neill, K. N. et al. Puberty timing and sex-specific trajectories of systolic blood pressure: a prospective cohort study. Hypertension 79, 1755–1764 (2022).

    Article  PubMed  Google Scholar 

  14. Hardy, R., Maddock, J., Ghosh, A. K., Hughes, A. D. & Kuh, D. The relationship between pubertal timing and markers of vascular and cardiac structure and function in men and women aged 60-64 years. Sci. Rep. 9, 11037 (2019).

    Article  PubMed  PubMed Central  ADS  Google Scholar 

  15. Hardy, R., Kuh, D., Whincup, P. H. & Wadsworth, M. E. Age at puberty and adult blood pressure and body size in a British Birth Cohort Study. J. Hypertens. 24, 59–66 (2006).

    Article  CAS  PubMed  Google Scholar 

  16. Huang, L. et al. Critical body fat percentage required for puberty onset: the Taiwan Pubertal Longitudinal Study. J. Endocrinol. Investig. 46, 1177–1185 (2023).

    Article  CAS  Google Scholar 

  17. Tanner, J. M. Normal growth and techniques of growth assessment. Clin. Endocrinol. Metab. 15, 411–451 (1986).

    Article  CAS  PubMed  Google Scholar 

  18. Chen, M. & Eugster, E. A. Central precocious puberty: update on diagnosis and treatment. Paediatr. Drugs 17, 273–281 (2015).

    Article  PubMed  PubMed Central  Google Scholar 

  19. Dong, Y. et al. National blood pressure reference for Chinese Han children and adolescents aged 7 to 17 years. Hypertension 70, 897–906 (2017).

    Article  CAS  PubMed  Google Scholar 

  20. Bouillet, L. Diagnostic Des Angioedèmes Héréditaires. La Presse Méd. 44, 52–56 (2015).

    Article  PubMed  Google Scholar 

  21. Demirel, M., Gürsoy, G. & Yıldız, M. Does treatment of either hypothyroidy or hyperthyroidy affect diurnal blood pressure. Arch. Iran. Med. 20, 572–580 (2017).

    PubMed  Google Scholar 

  22. Koutras, D. A. Disturbances of menstruation in thyroid disease. Ann. N. Y. Acad. Sci. 816, 280–284 (1997).

    Article  CAS  PubMed  ADS  Google Scholar 

  23. Jung, G. et al. Thyroid function in girls with central precocious puberty. Ann. Pediatr. Endocrinol. Metab. 24, 124–128 (2019).

    Article  PubMed  PubMed Central  Google Scholar 

  24. Fan, H. Y. et al. Hypertension as a novel link for shared heritability in age at menarche and cardiometabolic traits. J. Clin. Endocrinol. Metab. 108, 2389–2399 (2023).

    Article  PubMed  Google Scholar 

  25. Le-Ha, C. et al. Prenatal testosterone associates with blood pressure in young adults. Hypertension 77, 1756–1764 (2021).

    Article  CAS  PubMed  Google Scholar 

  26. Chinnathambi, V., Yallampalli, C. & Sathishkumar, K. Prenatal testosterone induces sex-specific dysfunction in endothelium-dependent relaxation pathways in adult male and female rats. Biol. Reprod. 89, 97 (2013).

    Article  PubMed  PubMed Central  Google Scholar 

  27. Cooper, R. et al. Validity of age at menarche self-reported in adulthood. J. Epidemiol. Community Health 60, 993–997 (2006).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Walker, I. V., Smith, C. R., Davies, J. H., Inskip, H. M. & Baird, J. Methods for determining pubertal status in research studies: literature review and opinions of experts and adolescents. J. Dev. Orig. Health Dis. 11, 168–187 (2020).

    Article  CAS  PubMed  Google Scholar 

  29. Calcaterra, V. et al. Hypertension during therapy with triptorelin in a girl with precocious puberty. Indian J. Pediatr. 80, 884–885 (2013).

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors thank the Ministry of Science and Technology of Taiwan for supporting the funding of our work and thank the WALLACE for the professional English editing.

Funding

This study was supported by a grant from the Ministry of Science and Technology (MOST 110-2628-B-038-014, MOST 111-2628-B-038-022, NSTC 112-2628-B-038-005).

Author information

Authors and Affiliations

  1. Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan

    Hsien-Yu Fan & Kuo-Liong Chien

  2. Department of Family Medicine, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan

    Hsien-Yu Fan, Li Huang & Yang-Ching Chen

  3. Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

    Hsien-Yu Fan, Wan-Ling Tsai, Shih-Yuan Hsu & Yang-Ching Chen

  4. Department of Health Promotion and Gerontological Care, College of LOHAS, Taipei University of Marine Technology, Taipei, Taiwan

    Wan-Ling Tsai

  5. Department of Family Medicine, Tun-Jen Clinic, Taoyuan, Taiwan

    Li Huang

  6. Department of Pediatrics, Cathay General Hospital, Taipei, Taiwan

    Jia-Woei Hou

  7. College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan

    Jia-Woei Hou

  8. Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    Meng-Che Tsai

  9. Department of Pediatrics, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan

    Chen Yang

  10. Ihmed Children Healthcare Center, Taipei, Taiwan

    Chen Yang

  11. School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan

    Yang-Ching Chen

  12. Graduate Institute of Metabolism and Obesity Sciences, Colledge of Nutrition, Taipei Medical University, Taipei, Taiwan

    Yang-Ching Chen

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  1. Hsien-Yu Fan
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Contributions

The original idea was conceived by H.Y.F., who also conducted all analyses, interpreted the data, and wrote the initial draft of the manuscript. W.L.T. and K.L.C. conducted interpreted the data and wrote the initial draft of the manuscript. S.Y.H. and L.H. conducted a part of analyses and interpreted the data. J.W.H., M.C.T., and C.Y. provided clinical advice on data interpretation and contributed to the revisions of the final manuscript. Y.C.C. ensured the accuracy of the analytical methods, supervised the findings, and contributed to the revisions of the final manuscript. All authors reviewed and approved the final manuscript and agreed to take responsibility for all aspects of the work.

Corresponding author

Correspondence to Yang-Ching Chen.

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Competing interests

The authors declare no competing interests.

Informed consent

Prior to the commencement of data collection, all participants and their parents/guardians completed the necessary procedures for informed and written consent (or assent, when applicable) to ensure their participation in the study.

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Fan, HY., Tsai, WL., Chien, KL. et al. Associations of central precocious puberty with blood pressure trajectories: prospective cohort study. Pediatr Res 95, 1147–1152 (2024). https://doi.org/10.1038/s41390-023-02908-4

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  • DOI: https://doi.org/10.1038/s41390-023-02908-4

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