Children with elevated blood pressure are more than twice as likely to carry hypertension into adulthood, according to a recent cohort study.

Researchers assessed the long-term predictive value of pediatric blood pressure (BP) levels, using American Academy of Pediatrics thresholds, for adult hypertension outcomes. This longitudinal analysis involved 2,918 participants (mean baseline age, 10.7 years) from the Cardiovascular Risk in Young Finns Study, with BP measured at multiple points over a 38-year follow-up period.

Key findings, published in JAMA Pediatrics, indicate that children with elevated BP had over double the likelihood of sustaining elevated BP or hypertension into adulthood (tracking coefficient odds ratio, 2.16; 95% confidence interval [CI], 1.95-2.39). Males had a higher probability than females of progressing to and maintaining hypertension; the probability of males with normal childhood BP developing stage 2 hypertension by midadulthood was 0.20 (95% CI, 0.17-0.22), compared with 0.08 (95% CI, 0.07-0.10) in females.

The study used multistate Markov modeling to estimate transition probabilities across BP classifications. Findings show that the probability of children maintaining normal BP into adolescence was 0.64 (95% CI, 0.60-0.67) for males and 0.81 (95% CI, 0.79-0.84) for females. However, this probability declined by young adulthood, with transition probabilities of 0.41 for males and 0.69 for females. Adolescents with elevated BP or hypertension had lower probabilities of returning to normotensive levels by midadulthood (transition probability range, 0.16-0.44), underscoring adolescence as a potential critical period for BP management interventions.

Full disclosures are available in the published study.