| dc.description.abstract | High blood pressure (BP) in childhood is associated with hypertension and cardiac structure in adulthood; however, little evidence exists for the relationship between childhood BP and adult cardiovascular disease (CVD). In addition, no genome-wide association studies of BP have been completed in a diverse population of children, although genetics play an important role in hypertension. We sought to investigate a) the association between childhood systolic blood pressure (SBP) trajectories and CVD risk factors in early adulthood and, b) whether genetic variants associated with SBP in adulthood are associated with SBP in children. Participants were children under the age of 18 years from the Vanderbilt University Medical Center de-identified electronic medical record database (n=8,706) and biobank, BioVU (n=9,778). Linear and logistic regression models were used to investigate the association between SBP trajectories, created using group-based trajectory modeling from all available outpatient measurements and corresponding percentiles, and the following outcomes after the age of 18 years: low-density lipoprotein, high-density lipoprotein, triglycerides, glucose, estimated glomerular filtration rate, body mass index (BMI), SBP, diabetes, obesity, and hypertension. A candidate SNP analysis and GWAS were used to examine the association between genetic variants and childhood and adolescent blood pressure percentile. A polygenic risk score (PRS) was calculated for each participant and the association between PRS and median SBP percentile in childhood was examined using linear regression. The three trajectories identified were high-high SBP percentile, low-mid SBP percentile, and high-low SBP percentile with 53%, 31%, and 16% of participants, respectively. Compared to participants in the high-high SBP trajectory, participants in the high-low SBP trajectory had lower glucose, BMI, SBP and lower odds of diabetes and hypertension in early adulthood. In the overall candidate SNP analysis, two SNPs reached significance: rs1018148 (FBN1) and rs11105354 (ATP2B1). In the post-puberty age group, one SNP reached significance: rs1018148 (FBN1). Higher PRS was associated with higher SBP percentile and there was a significant interaction with age. Our results suggest that childhood BP is associated with early adulthood outcomes and age-specific genetic variants of BP are important in childhood. Understanding BP during early life is important to reduce cardiovascular consequences in adulthood. | |
