A child’s blood pressure at just seven years old may hold clues to their heart health decades later, according to a new Northwestern Medicine study published in JAMA.
The findings strengthen the case for early cardiovascular screening, said Alexa Freedman, PhD, assistant professor of Preventive Medicine in the Division of Epidemiology and first author of the study.
“This is one of the first studies to show that even small differences in blood pressure at age seven — whether systolic or diastolic — can have long-term consequences,” Freedman said. “We were surprised by the timing — that blood pressure at such an early age is linked with outcomes up to 50 years later.”
In the study, scientists analyzed data from the Collaborative Perinatal Project, the largest U.S.-based pregnancy cohort, which followed more than 30,000 children born between 1959 and 1965. Investigators found that both elevated systolic and diastolic blood pressure in childhood were associated with increased risk of premature cardiovascular death in adulthood.
Children with blood pressure in the 90–94th percentile (elevated blood pressure) or at or above the 95th percentile (hypertension) had a 40–50 percent greater risk of dying from cardiovascular disease later in life, according to the study. The risk was independent of body mass index (BMI), meaning that even children who were not overweight but had high blood pressure were still at increased risk.
To further test their findings, Freedman and her collaborators conducted a sibling analysis using 150 sibling pairs. This method enabled them to control for shared family factors, including genetics and home environment. The results showed that the sibling with higher systolic blood pressure had a higher risk of cardiovascular mortality than their sibling with lower blood pressure, consistent with the findings from the main analysis.
Freedman said the results emphasize the need for improved screening and awareness.
“Even in childhood, blood pressure matters. This suggests that higher blood pressure in childhood may have serious implications for health across the life course,” she said. “The key message for the public is the importance of knowing your child’s blood pressure numbers.”
For healthcare providers and policymakers, the study underscores the importance of routine blood pressure screening in children and the importance of research on public health initiatives aimed at lifestyle change and promoting cardiovascular health from a young age, Freedman said.
“Many kids aren’t having their blood pressure assessed at well-child visits,” Freedman said. “Improving adherence to screening guidelines could be one way of catching high blood pressure in childhood, potentially improving health outcomes across a child’s lifetime.”
The study was funded by the National Heart, Lung, and Blood Institute and the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development.
