Dataset Information

Dynamic prediction of childhood high blood pressure in a population-based birth cohort: a model development study.

ABSTRACT: OBJECTIVES:To develop a dynamic prediction model for high blood pressure at the age of 9-10 years that could be applied at any age between birth and the age of 6 years in community-based child healthcare. DESIGN, SETTING AND PARTICIPANTS:Data were used from 5359 children in a population-based prospective cohort study in Rotterdam, the Netherlands. OUTCOME MEASURE:High blood pressure was defined as systolic and/or diastolic blood pressure ?95th percentile for gender, age and height. Using multivariable pooled logistic regression, the predictive value of characteristics at birth, and of longitudinal information on the body mass index (BMI) of the child until the age of 6 years, was assessed. Internal validation was performed using bootstrapping. RESULTS:227 children (4.2%) had high blood pressure at the age of 9-10 years. Final predictors were maternal hypertensive disease during pregnancy, maternal educational level, maternal prepregnancy BMI, child ethnicity, birth weight SD score (SDS) and the most recent BMI SDS. After internal validation, the area under the receiver operating characteristic curve ranged from 0.65 (prediction at age 3 years) to 0.73 (prediction at age 5-6 years). CONCLUSIONS:This prediction model may help to monitor the risk of developing high blood pressure in childhood which may allow for early targeted primordial prevention of cardiovascular disease.

SUBMITTER: Hamoen M

PROVIDER: S-EPMC6252684 | biostudies-literature | 2018 Nov

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Dynamic prediction of childhood high blood pressure in a population-based birth cohort: a model development study.

Hamoen Marleen M Vergouwe Yvonne Y Wijga Alet H AH Heymans Martijn W MW Jaddoe Vincent W V VWV Twisk Jos W R JWR Raat Hein H de Kroon Marlou L A MLA

BMJ open 20181121 11

<h4>Objectives</h4>To develop a dynamic prediction model for high blood pressure at the age of 9-10 years that could be applied at any age between birth and the age of 6 years in community-based child healthcare.<h4>Design, setting and participants</h4>Data were used from 5359 children in a population-based prospective cohort study in Rotterdam, the Netherlands.<h4>Outcome measure</h4>High blood pressure was defined as systolic and/or diastolic blood pressure ≥95th percentile for gender, age and ...[more]

PMID: 30467134

Similar Datasets

Project description:BackgroundIn 2005, it was estimated that hypertension affected 26.4% of the adult population worldwide. By 2025, it is predicted that it will affect about 60% of adults, a total of 1.56 billion. Both pre- and postnatal growth patterns have been associated with later blood pressure (BP), but in contrasting directions. These inconsistent associations of growth during different developmental periods merit elucidation. We tested a theoretical model treating birth weight as a marker of homeostatic metabolic capacity, and childhood height, lean mass and fat mass as independent indices of metabolic load. We predicted that decreased capacity and increased load would be independently associated with increased BP.Methods and findingsData from the ALSPAC cohort on growth from birth to 7 years, and body composition by dual-energy X-ray absorptiometry and BP at 9 years, were analysed (n?=?6579). Data were expressed as standard deviation scores (SDS) or standardised regression residuals (SRR). BP was independently and positively associated with each of height, lean mass and fat mass. In a joint model systolic BP was positively associated with conditional weight velocity [males 0.40 (95%CI: 0.37-0.44) & females 0.44 (95%CI: 0.40-0.47) SDS/SRR], but not birth weight [0.00 (95%CI: -0.03-0.04) & 0.03 (95%CI: -0.01-0.07) SDS/SDS]. Adjusting for height, lean mass and fat mass, the association of systolic BP and conditional weight velocity attenuated [0.00(95%CI: -0.09-0.08) & -0.06(95%CI: -0.14-0.03) SDS/SRR], whereas that with birth weight became negative [-0.10 (95%CI: -0.14-0.06) & -0.09 (95%CI: -0.13-0.05) SDS/SDS]. Similar results were obtained for diastolic BP and pulse pressure.ConclusionsConsistent with our theoretical model, high metabolic load relative to metabolic capacity is associated with increased BP. Our data demonstrate the contribution of different growth and body composition components to BP variance, and clarify the developmental aetiology of hypertension.

Project description:Study questionCan routine antenatal blood pressure measurements between 20 and 36 weeks' gestation contribute to the prediction of pre-eclampsia and its associated adverse outcomes?MethodsThis study used repeated antenatal measurements of blood pressure from 12 996 women in the Avon Longitudinal Study of Parents and Children (ALSPAC) to develop prediction models and validated these in 3005 women from the Southampton Women's Survey (SWS). A model based on maternal early pregnancy characteristics only (BMI, height, age, parity, smoking, existing and previous gestational hypertension and diabetes, and ethnicity) plus initial mean arterial pressure was compared with a model additionally including current mean arterial pressure, a model including the deviation of current mean arterial pressure from a stratified normogram, and a model including both at different gestational ages from 20-36 weeks.Study answer and limitationsThe addition of blood pressure measurements from 28 weeks onwards improved prediction models compared with use of early pregnancy risk factors alone, but they contributed little to the prediction of preterm birth or small for gestational age. Though multiple imputation of missing data was used to increase the sample size and minimise selection bias, the validation sample might have been slightly underpowered as the number of cases of pre-eclampsia was just below the recommended 100. Several risk factors were self reported, potentially introducing measurement error, but this reflects how information would be obtained in clinical practice.What this study addsThe addition of routinely collected blood pressure measurements from 28 weeks onwards improves predictive models for pre-eclampsia based on blood pressure in early pregnancy and other characteristics, facilitating a reduction in scheduled antenatal care.Funding, competing interests, data sharingUK Wellcome Trust, US National Institutes of Health, and UK Medical Research Council. Other funding sources for authors are detailed in the full online paper. With the exceptions of CM-W, HMI, and KMG there were no competing interests.

Dataset Information

Dynamic prediction of childhood high blood pressure in a population-based birth cohort: a model development study.

Publications

Dynamic prediction of childhood high blood pressure in a population-based birth cohort: a model development study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets