Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Special Issue: Current evidence and perspectives for hypertension management in Asia
  • Published:

Associations of blood pressure trajectories in early life with target organ damage in midlife : a 30-year cohort study

Hypertension Research volume 46, pages 2613–2621 (2023)Cite this article

Abstract

Hypertension is a pivotal factor in cardiovascular risk. However, the association of longitudinal blood pressure (BP) trajectories in the early life and cardiovascular risk assessed by target organ damage (TOD) in adulthood is poorly reported. The objective of this study was to identify the association between systolic BP, diastolic BP, and mean atrial pressure (MAP) trajectories early in life with a single or multiple TOD in later life. We identified BP trajectories from 6 to 45 year-old using group-based trajectory models among 2430 individuals in the Hanzhong Adolescent Hypertension Study and examined the relationship between BP trajectories and cardiovascular risk in later life. Four discrete long-term systolic BP, diastolic BP, and MAP trajectories were identified, namely, low stable, moderate stable, high stable (low increasing), and moderate increasing groups, based on the BP levels at baseline and in the 30-year follow-up. The carotid intima-media thickness were higher in persistently high or increasing trajectories in comparison to the low stable group. Individuals with deteriorative trajectories during early life were at an increased risk of suffering from a single TOD, including left ventricular hypertrophy (LVH) and carotid atherosclerosis (CA) in middle age (36–49 years old). Moreover, higher BP trajectories were correlated with the presence of combined TODs load stage which were assessed by CA, LVH, arteriosclerosis and subclinical renal damage (SRD). Higher longitudinal BP trajectories early in life were associated with increased cardiovascular risk in midlife, and identifying BP trajectories in early life can help screen individuals with TOD later.

LVH, left Ventricular Hypertrophy; CA, carotid atherosclerosis; SRD, subclinical renal damage; TOD, target organ damage.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. GBD 2016 DALYs and HALE Collaborators. Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390:1260–344.

    Article  Google Scholar 

  2. Pan H, Hibino M, Kobeissi E, Aune D. Blood pressure, hypertension and the risk of sudden cardiac death: a systematic review and meta-analysis of cohort studies. Eur J Epidemiol. 2020;35:443–54.

    Article  PubMed  Google Scholar 

  3. Mansia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, et al. Guidelines for the management of arterial hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2007;28:1462–536.

    Google Scholar 

  4. Volpe M, Battistoni A, Tocci G, Rosei EA, Catapano AL, Coppo R, et al. Cardiovascular risk assessment beyond Systemic Coronary Risk Estimation: a role for organ damage markers. J Hypertens. 2012;30:1056–64.

    Article  CAS  PubMed  Google Scholar 

  5. Harbaoui B, Courand PY, Defforges A, Khettab F, Milon H, Girerd N, et al. Cumulative Effects of Several Target Organ Damages in Risk Assessment in Hypertension. Am J Hypertens. 2016;29:234–44.

    Article  CAS  PubMed  Google Scholar 

  6. Sehestedt T, Jeppesen J, Hansen TW, Wachtell K, Ibsen H, Torp-Pedersen C, et al. Risk prediction is improved by adding markers of subclinical organ damage to SCORE. Eur Heart J. 2010;31:883–91.

    Article  Google Scholar 

  7. Kollias A, Lagou S, Zeniodi ME, Boubouchairopoulou N, Stergiou GS. Association of Central Versus Brachial Blood Pressure With Target-Organ Damage: Systematic Review and Meta-Analysis. Hypertension. 2016;67:183–90.

    Article  CAS  Google Scholar 

  8. Zheng W, Mu J, Chu C, Hu J, Yan Y, Ma Q, et al. Association of Blood Pressure Trajectories in Early Life with Subclinical Renal Damage in Middle Age. J Am Soc Nephrol. 2018;29:2835–46.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Devereux RB, Wachtell K, Gerdts E, Boman K, Nieminen MS, Papademetriou V, et al. Prognostic significance of left ventricular mass change during treatment of hypertension. JAMA. 2004;292:2350–6.

    Article  CAS  Google Scholar 

  10. Chrispin J, Jain A, Soliman EZ, Guallar E, Alonso A, Heckbert SR, et al. Association of electrocardiographic and imaging surrogates of left ventricular hypertrophy with incident atrial fibrillation: MESA (Multi- Ethnic Study of Atherosclerosis). J Am Coll Cardiol. 2014;63:2007–13.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Nagin DS, Odgers CL. Group-based trajectory modeling in clinical research. Annu Rev Clin Psychol. 2010;6:109–38.

    Article  PubMed  Google Scholar 

  12. Marioni RE, Proust-Lima C, Amieva H, Brayne C, Matthews FE, Dartigues JF, et al. Cognitive lifestyle jointly predicts longitudinal cognitive decline and mortality risk. Eur J Epidemiol. 2014;29:211–9.

    Article  PubMed Central  Google Scholar 

  13. Tientcheu D, Ayers C, Das SR, McGuire DK, de Lemos JA, Khera A, et al. Target Organ Complications and Cardiovascular Events Associated With Masked Hypertension and White-Coat Hypertension: Analysis From the Dallas Heart Study. J Am Coll Cardiol. 2015;66:2159–69.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Townsend RR, Wilkinson IB, Schiffrin EL, Avolio AP, Chirinos JA, Cockcroft JR, et al. Recommendations for Improving and Standardizing Vascular Research on Arterial Stiffness: A Scientific Statement From the American Heart Association. Hypertension. 2015;66:698–722.

    Article  CAS  Google Scholar 

  15. Xie X, Atkins E, Lv J, Bennett A, Neal B, Ninomiya T, et al. Effects of intensive blood pressure lowering on cardiovascular and renal outcomes: updated systematic review and meta- analysis. Lancet. 2016;387:435–43.

    Article  PubMed  Google Scholar 

  16. Wang F, Zhao H, Yang C, Kong G, Song L, Li C, et al. Association of blood pressure in the supine position with target organ damage in subjects over 60 years old. J Int Med Res. 2017;45:123–33.

    Article  Google Scholar 

  17. Gaborieau V, Delarche N, Gosse P. Ambulatory blood pressure monitoring versus self-measurement of blood pressure at home: correlation with target organ damage. J Hypertens. 2008;26:1919–27.

    Article  CAS  Google Scholar 

  18. Buscot MJ, Thomson RJ, Juonala M, Sabin MA, Burgner DP, Lehtimäki T, et al. Distinct child-to-adult body mass index trajectories are associated with different levels of adult cardiometabolic risk. Eur Heart J. 2018;39:2263–70.

    Article  Google Scholar 

  19. Das SK, McIntyre HD, Mamun AA. An early life course association of pulse pressure with adulthood estimated glomerular filtration rate: evidence from a large community-based birth cohort study. J Hypertens. 2017;35:392–400.

    Article  CAS  PubMed  Google Scholar 

  20. Theodore RF, Broadbent J, Nagin D, Ambler A, Hogan S, Ramrakha S, et al. Childhood to Early-Midlife Systolic Blood Pressure Trajectories: Early-Life Predictors, Effect Modifiers, and Adult Cardiovascular Outcomes. Hypertension. 2015;66:1108–15.

    Article  CAS  PubMed  Google Scholar 

  21. Wu Z, Jin C, Vaidya A, Jin W, Huang Z, Wu S, et al. Longitudinal Patterns of Blood Pressure, Incident Cardiovascular Events, and All-Cause Mortality in Normotensive Diabetic People. Hypertension. 2016;68:71–7.

    Article  CAS  Google Scholar 

  22. Hao G, Wang X, Treiber FA, Harshfield G, Kapuku G, Su S. Blood Pressure Trajectories From Childhood to Young Adulthood Associated With Cardiovascular Risk: Results From the 23-Year Longitudinal Georgia Stress and Heart Study. Hypertension. 2017;69:435–42.

    Article  CAS  PubMed  Google Scholar 

  23. Allen NB, Siddique J, Wilkins JT, Shay C, Lewis CE, Goff DC, et al. Blood pressure trajectories in early adulthood and subclinical atherosclerosis in middle age. JAMA. 2014;311:490–97.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Ostbye T, Malhotra R, Landerman LR Body mass trajectories through adulthood: results from the National Longitudinal Survey of Youth 1979 Cohort (1981-2006). Int J Epidemiol. 2011;40:240–50.

  25. Strandberg TE, Salomaa VV, Vanhanen HT, Pitkälä K, Miettinen TA. Isolated diastolic hypertension, pulse pressure, and mean arterial pressure as predictors of mortality during a follow-up of up to 32 years. J Hypertens. 2002;20:399–404.

    Article  CAS  PubMed  Google Scholar 

  26. Nambi V, Chambless L, Folsom AR, He M, Hu Y, Mosley T, et al. Carotid intima-media thickness and presence or absence of plaque improves prediction of coronary heart disease risk: the ARIC (Atherosclerosis Risk In Communities) study. J Am Coll Cardiol. 2010;55:1600–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Mattace-Raso FU, van der Cammen TJ, Hofman A, van Popele NM, Bos ML, Schalekamp MA, et al. Arterial stiffness and risk of coronary heart disease and stroke: the Rotterdam Study. Circulation. 2006;113:657–63.

    Article  Google Scholar 

  28. Sarnak MJ, Levey AS, Schoolwerth AC, Coresh J, Culleton B, Hamm LL, et al. Kidney disease as a risk factor for development of cardiovascular disease: a statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention. Circulation. 2003;108:2154–69.

    Article  Google Scholar 

  29. Perrone-Filardi P, Coca A, Galderisi M, Paolillo S, Alpendurada F, de Simone G, et al. Noninvasive cardiovascular imaging for evaluating subclinical target organ damage in hypertensive patients: a consensus article from the European Association of Cardiovascular Imaging, the European Society of Cardiology Council on Hypertension and the European Society of Hypertension. J Hypertens. 2017;35:1727–41.

    Article  CAS  Google Scholar 

  30. Alberts MJ, Bhatt DL, Mas JL, Ohman EM, Hirsch AT, Röther J, et al. Three-year follow-up and event rates in the international REduction of Atherothrombosis for Continued Health Registry. Eur Heart J. 2009;30:2318–26.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Hoshide S, Kario K, de la Sierra A, Bilo G, Schillaci G, Banegas JR, et al. Ethnic differences in the degree of morning blood pressure surge and in its determinants between Japanese and European hypertensive subjects: data from the ARTEMIS study. Hypertension. 2015;66:750–6.

    Article  CAS  Google Scholar 

Download references

Funding

Funding

This work was supported by grants 81870319 (J-JM), 81570381 (J-JM), 82200472 (W-LZ) and 81700368 (CC) from the National Natural Science Foundation of China, grant 2017YFC1307604 from the Major Chronic Non-communicable Disease Prevention and Control Research Key Project of the Ministry of Science and Technology of the People’s Republic of China, grant 2017ZDXM-SF-107 from the Key Research Project of Shaanxi Province, and grant XJTU1AF-CRF-2019-004 from the Clinical Research Award of the First Affiliated Hospital of Xi’an Jiaotong University. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Author information

Authors and Affiliations

  1. Department of Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi’an, PR China

    Wenling Zheng, Jianjun Mu, Yu Yan, Chao Chu & Ziyue Man

  2. Department of Geriatric-Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, PR China

    Wenling Zheng, Xianming Su, Wei Zhang & Dan Luo

Authors
  1. Wenling Zheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jianjun Mu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yu Yan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Chao Chu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Xianming Su
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ziyue Man
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Wei Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Dan Luo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jianjun Mu.

Ethics declarations

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zheng, W., Mu, J., Yan, Y. et al. Associations of blood pressure trajectories in early life with target organ damage in midlife : a 30-year cohort study. Hypertens Res 46, 2613–2621 (2023). https://doi.org/10.1038/s41440-023-01387-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41440-023-01387-8

Keywords

This article is cited by

Search

Advanced search

Quick links