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LEVEL, TREND AND VARIABILITY OF BLOOD PRESSURE DURING CHILDHOOD: THE MUSCATINE STUDY

Prediction of hypertension occurring in adult life from pressures measured at one point in time in childhood is difficult because BP in children tracks in different ways. From BP and body size measures in 4313 children (initial age 5-13 years) examined longitudinally at two-year intervals for a decade, the following were calculated: mean of age-sex-survey specific percentiles as a measure of level (L); slope of percentiles over time as a measure of trend (T); average difference from the regression line as a measure of variability (V). L,T,V of BP were divided into quintiles with the first and fifth quintiles used to define low and high limits: 5% appear to be tracking towards high SBP with either high L, flat T, and low V, or high L, high T, and low V; 7.5% had labile high SBP with high L and high V. Correlations (p<0.001) between L of SBP with L of height, weight, relative weight were 0.31, 0.47, and 0.35 respectively; and correlations between T of SBP with T of body size measures were 0.16, 0.26, and 0.17 respectively. The direct relationship of L T of BP to body size indicates that higher BP occurs in tall, obese children or those with accelerated growth. Thus although final rank of BP may not be established until growth is complete, there are groups of children that can be identified who appear to be tracking towards future high blood pressure.