Peer-reviewed article
Childhood BMI trajectories and hypertension in adulthood: a population-based cohort study.
Searle D, Andersen EW, Aarestrup J, Baker JL ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study followed over 124,000 Danish children from ages 6-15 into adulthood to understand how childhood weight patterns affect high blood pressure later in life. Children with higher body mass index trajectories—especially those on an obesity path—had significantly higher rates of hypertension as adults, with the strongest associations appearing in young adulthood (ages 25-39). The risk remained elevated even at ages 50-62, though the magnitude of association decreased with age. These findings suggest that preventing childhood obesity could reduce the burden of hypertension in adulthood.
Key points
- Over 18 years of follow-up, 9.4% of men and 9.3% of women developed hypertension
- Children on an obesity BMI trajectory had 4.31 times higher risk of hypertension at ages 25-39 compared to average trajectory children
- The association between childhood obesity trajectory and hypertension persisted into later adulthood (ages 50-62) with hazard ratio of 2.12 for men and 2.19 for women
- The dose-response relationship showed that above-average and overweight trajectories also increased hypertension risk, though less than obesity
- Associations between childhood BMI trajectories and hypertension attenuated but remained statistically significant with advancing age
Limitations
The study is observational and cannot establish causation, only association. The cohort is entirely from Denmark and findings may not generalise to other populations with different genetic backgrounds, environments, or healthcare systems.
Abstract
Higher body mass index (BMI) in childhood is associated with hypertension (HTN) especially in young adulthood. We examined whether longitudinal patterns of BMI development in childhood are associated with HTN across adult ages. We included 124 670 children (51% boys), born between 1960-1996, from the Copenhagen School Health Records Register with height and weight measurements at ages 6-15 years. Latent class trajectory models were used to identify five sex-specific BMI trajectories: below-average, average, above-average, overweight, and obesity. Individuals were followed from age 25 in national health registers from 1995-2022 for HTN. Cox models were used to estimate sex-specific hazard ratios (HRs) with 95% confidence intervals (CIs) for HTN across childhood BMI trajectories, with adjustment for birth cohort and parental education. Follow-up was split into ages 25-39, 40-49, and 50-62 years. Over a median 18-year follow-up, 5 970 men (9.4%) and 5 712 women (9.3%) developed HTN. Men and women with above-average, overweight, and obesity childhood BMI trajectories had higher hazards of HTN than those with the average trajectory. Associations attenuated with age but remained significant. Compared to men with the average trajectory, the obesity trajectory was associated with a HR = 4.31 (95% CI: 3.45-5.37) at ages 25-39 and HR = 2.12 (1.63-2.76) at ages 50-62 years. Compared to women with the average trajectory, the obesity trajectory was associated with a HR = 3.53 (2.89-4.30) at ages 25-39 and HR = 2.19 (1.70-2.82) at ages 50-62 years. Childhood BMI trajectories are positively associated with adult HTN in a dose-response manner highlighting the potential value of early obesity prevention.