A new study shows children with hypertension (high blood pressure) are more than two times as likely to go on to experience a major cardiovascular complication by early adulthood compared to children without hypertension. The results, published in JAMA Pediatrics, may hold important implications for children with chronic kidney disease who have hypertension too.
There is a close relationship between kidney disease, hypertension and cardiovascular disease. Yet it can be difficult and costly to follow children for many years to study long-term outcomes, when they have one condition until they develop another.
“Intuitively we knew what was happening in childhood was going to have a big impact on adulthood,” explains Dr. Janis Dionne, an investigator with BC Children’s Hospital. “But trying to prove that has been really difficult.”
To find answers, Dionne collaborated with researchers in Ontario to design a study, analyzing health records of more than 25,000 children with hypertension between the ages of 3 and 18, comparing their cardiovascular health outcomes to children without hypertension. On average, each person’s health records included 14 years of follow-up data.
The results show children with hypertension are 2.1 times more likely to experience a major adverse cardiac event by the age of 27. In particular, these patients were at 2.7 times higher risk of stroke, 1.8 times higher risk of heart attack or angina, 4 times higher risk of having a coronary intervention, and 2.6 times higher risk of experiencing congestive heart failure.
Dionne says she was worried that the follow-up period of 14 years wouldn’t be long enough to detect major differences between the two groups, given how the people in the study were only 27 years old on average by the end of the study. “So I was actually shocked at how drastic and how strong the effect was even at young adulthood ages,” she says.
Of note, about 50 to 60 percent of children with kidney disease also have hypertension, and this combination is known to make kidney disease progress faster. In the next study, Dionne says they are taking a similar approach, analyzing long-term health records of children (which are anonymized for privacy), to explore the link between childhood hypertension and going on to develop kidney disease in adulthood.
