Elevated blood pressure in early adulthood as a predictor of later coronary heart disease mortality

Objective: To investigate whether variations in growth patterns in early-life are associated with blood pressure at age 6.5 years by modelling detailed, individual growth trajectories between birth and 5 years of age. Design: Prospective cohort study nested in a large randomised trial. Setting: Belarus. Participants: 10 494 children from Belarus who were born in one of 31 hospitals that participated in a cluster randomised trial of breastfeeding promotion intervention and had multiple measures of height and weight from birth to age 6.5 years. We analysed all 13 childhood growth measurements to develop a best-fitting linear spline random-effects model with 2 knots (thus dividing follow-up into 3 time periods, each with its own trajectory). The spline models were used to generate 4 random effects coefficients: birthweight; ''early infant weight velocity'' (birth-3 mo); ''late infant weight velocity'' (3 mo-1 yr) and ''childhood weight velocity'' (1-5 yrs). Each coefficient denotes an individual's deviance from average birthweight or velocity at each time period; together, the coefficients are a withinsubject summary of each child's growth curve from birth to 5 years. The coefficients were converted into age-standardised z-scores to render them directly comparable. Main Outcome Measures: Systolic and diastolic blood pressure (mm Hg) measured at age 6.5 years. Sex-specific OLS was used to investigate associations of each coefficient with blood pressure, controlled for hospital and baseline confounders

Blood pressure · Cardiology · Cardiovascular health · Coronary disease · Coronary heart disease · Disease · Birth, Development, and Health · Internal Medicine · Medicine · Gerontology