Lifetime Growth and Blood Pressure in Adolescence: Hong Kong’s “Children of 1997” Birth Cohort

OBJECTIVES: Blood pressure tracks from adolescence to adulthood and is positively associated with low birth weight and faster infant growth. Most observations are from Western populations; it is unclear whether these are biologically based or contextually specific. We examined the associations of growth with blood pressure in adolescence. METHODS: Multivariable partial least squares regression was used to assess the associations of growth to ∼11 years with blood pressure at ∼11 years in 5813 term births from Hong Kong’s Children of 1997 birth cohort. Growth was considered as genderand age-specific zscores for birth weight, BMI, and length at 3 months; change in zscores for BMI and height at 3 to 9 months, 9 to 36 months, 3 to 7 years, and 7 to 11 years; and BMI and height at 11 years. RESULTS: Birth weight was weakly inversely associated with systolic blood pressure in girls –0.58 mm Hg 95% confidence interval –1.05 to –0.12 (boys –0.21, –0.71 to 0.30). Childhood growth, particularly linear growth at 7 to 11 years (girls: 1.27, 0.56 to 1.98; boys 2.11, 1.39 to 2.83), as well as current height (girls: 2.40, 2.04 to 2.76, boys: 2.65, 2.29 to 3.01) and BMI (girls: 2.72, 2.35 to 3.09, boys: 2.72, 2.09 to 3.36) were associated with higher systolic blood pressure. Diastolic blood pressure was also positively associated with current size. CONCLUSIONS: In the first study to examine simultaneously the role of preand postnatal growth in adolescent blood pressure, the role of late childhood growth predominated. Pediatrics 2013;131:e62–e72 AUTHORS: Michelle Heys, MD,ab Shi Lin Lin, MPH,a Tai Hing Lam, MD,a Gabriel M. Leung, MD,a and C. Mary Schooling, PhDac aLifestyle and Life Course Epidemiology Group, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; bCenter for International Child Health and Development, Institute of Child Health, Great Ormond Street Hospital, University College London, London, United Kingdom; and cCUNY School of Public Health at Hunter College, New York, New York