Childhood and Pubertal BMI Associations with Midlife Blood Pressure and Hypertension
Overview
This study found that increases in BMI during puberty are positively associated with higher blood pressure and hypertension risk in midlife for both men and women, with these effects largely mediated by midlife BMI. Additionally, childhood BMI was linked to higher blood pressure in men but not women, independent of pubertal BMI changes.
Background
Cardiovascular disease is a leading cause of death globally, with high blood pressure as a major risk factor. Excess weight in adulthood is known to increase cardiovascular and hypertension risk, but the impact of BMI during childhood and puberty on midlife blood pressure is less clear. Previous studies have shown mixed results regarding the relationship between developmental BMI and later blood pressure. This study leverages linked longitudinal data from Swedish cohorts to clarify these associations and explore the mediating role of midlife BMI.
Data Highlights
Variable
Association with Midlife Blood Pressure/Hypertension
Significance
Gender Differences
Pubertal BMI Change
Positive association with systolic and diastolic BP and hypertension
P < 0.01
Both men and women
Childhood BMI
Positive association with systolic and diastolic BP
P < 0.01
Men only
Childhood BMI
No significant independent association with hypertension
Not significant
Both genders
Mediation by Midlife BMI
Pubertal BMI change effects on BP and hypertension largely mediated by midlife BMI
Confirmed by mediation analysis
Both genders
Key Findings
Pubertal BMI increase is strongly linked to higher systolic and diastolic blood pressure and hypertension risk in midlife for both sexes.
Childhood BMI predicts higher blood pressure in midlife for men but not for women, independent of pubertal BMI changes.
No independent association was found between childhood BMI and hypertension in either gender.
The relationship between pubertal BMI change and midlife blood pressure/hypertension is largely mediated through BMI measured in midlife.
These findings support the concept that high blood pressure may originate in early life stages.
Clinical Implications
These results highlight the importance of monitoring and managing BMI during childhood and puberty to reduce the risk of hypertension and cardiovascular disease later in life. Interventions targeting healthy weight maintenance starting in developmental years could have long-term benefits in preventing elevated blood pressure. Clinicians should consider a life-course approach to cardiovascular risk reduction beginning early in life.
Conclusion
BMI changes during puberty significantly influence midlife blood pressure and hypertension risk, primarily through their impact on midlife BMI. Early-life weight management may be a key strategy to reduce adult hypertension burden.
References
BMI Epidemiology Study Gothenburg & SCAPIS Cohort -- Childhood and Pubertal BMI: Links to Blood Pressure and Hypertension in Midlife
