{
  "abstract": "The incidence of hypertension in childhood is increasing. Long term studies of the impact of high blood pressure in childhood on adult long term outcomes, such as mortality, are few. Freedman AA et al (JAMA 2025;334:1555–15557. Doi:10.1001/jama.2025.14405) have examined the association between blood pressure (BP) at age 7 years and cardiovascular disease (CVD) mortality in over 37 000 children (born between 1959 and 1965) who were followed up into their sixth decade of life. This was a prospective study of children born to a cohort of women who were enrolled in the Collaborative Perinatal Project (CPP) which was conducted in 12 sites over the United States of America. At age 7 years, a single BP was obtained by a paediatrician or nurse using a manual sphygmomanometer. Systolic BP (SBP) and diastolic BP (DBP) were converted to percentiles (for age, sex, and height) and classified into three groups: normal (<90 th percentile), elevated (90th-94th percentile), or hypertension (≥95 th percentile). Over 21% of children were classified with hypertension. Over the follow-up period, which was a median (IQR) follow-up through age 54 (52-55) years, there were 487 cardiovascular and 2242 non-cardiovascular deaths. A 1-SD higher SBP (unadjusted HR (HR), 1.15 [95% CI, 1.04 to 1.26]; adjusted HR (aHR), 1.14 [95% CI, 1.03 to 1.26]) and DBP (unadjusted HR, 1.17 [95% CI, 1.07 to 1.29]; aHR, 1.18 [95% CI, 1.07 to 1.29]) at age 7 years was significantly associated with premature CVD mortality. Although this study was based on a single BP measurement the hypertension rates aligned with nationally representative data. Early-life cardiovascular health promotion focussing on monitoring and modifying BP-associated risk, is important (see below!).",
  "authors": [
    {
      "affiliations": [],
      "name": "BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health"
    }
  ],
  "title": "Highlights from the literature",
  "uid": "7507087b-9b33-5df9-b0e1-1a648bb14d7b"
}