# Childhood occasional hypertension and its association with size at birth and early growth: a population-based retrospective cohort study from China

## TL;DR

This study finds that childhood occasional hypertension is linked to low birth weight, obesity, and rapid early growth in Chinese children.

## Contribution

The study identifies specific risk factors for childhood occasional hypertension, including birth weight and early growth patterns.

## Key findings

- Childhood occasional hypertension prevalence is 17.0% among 5-6 year olds in Tianjin, China.
- Low birth weight and excessive early growth increase the risk of childhood occasional hypertension.
- Obesity at 5-6 years old is a strong risk factor for childhood occasional hypertension.

## Abstract

Hypertension has recently shown a rapid rise in prevalence among children and adolescents. It can track into adulthood and tend to manifest at an earlier age. It should be prevented urgently and efficiently.

This study assesses the prevalence of occasional hypertension (OHTN) at 5 ~ 6 years old and evaluates its association with size at birth and BMI at 2 and 5 ~ 6 years old in full-term children. We conducted a population-based cohort study of 12,564 children from 66 kindergartens in Tianjin, China. Information on birth weight, body mass index (BMI) at 2 and 5 ~ 6 years old, and blood pressure at 5 ~ 6 years old was retrospectively collected.

The prevalence of childhood OHTN (SBP or DBP ≥ P95 percentile for sex, age, and height) was 17.0%. At birth, SGA has a high risk of OHTN (AOR 1.36, 95%CI 1.10–1.68). In the SGA subgroup, although children are of normal weight at 5 ~ 6 years old, excessive catch-up growth (BMI ≥75th at 2 years old) was still attributed to OHTN (OR 1.51, 95%CI 1.03–2.24). Obesity (BMI ≥2SD at 5 ~ 6 years old) was a vital risk factor for OHTN (AOR 2.93, 95%CI 2.56–3.36) unregarding with birthweight (OR 95%CI: SGA 3.23(1.66 ~ 6.27), AGA 2.83 (2.42–3.31), LGA 3.52 (2.65–4.68)). The co-presence of moderate or excessive catch-up growth before 2 years old and obesity at 5 ~ 6 years old significantly increased the risk of childhood OHTN (OR from 2.74 (1.65–4.54) to 6.53 (2.68–15.90)).

Preschool obesity, low birth weight, and excessive catch-up growth increased the risk of OHTN in childhood.