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Abstract: TH-PO695

Individuals Born Preterm Have an Increased Rate of Hypertension from Adolescence to Adulthood

Session Information

Category: Hypertension and CVD

  • 1401 Hypertension and CVD: Epidemiology, Risk Factors, and Prevention

Authors

  • South, Andrew M., Wake Forest School of Medicine, Winston Salem, North Carolina, United States
  • Jensen, Elizabeth T., Wake Forest School of Medicine, Winston Salem, North Carolina, United States
  • Nixon, Patricia A., Wake Forest University, Winston Salem, North Carolina, United States
  • Washburn, Lisa K., Wake Forest School of Medicine, Winston Salem, North Carolina, United States
Background

Preterm birth increases the lifetime risk of hypertension (HTN), but the prevalence of HTN in adolescents and adults and the change in blood pressure (BP) and incidence of HTN from adolescence into adulthood are undescribed. We hypothesized that subjects born preterm have an increased prevalence of high BP and HTN, a greater increase in BP/yr, and an increased incidence of high BP and HTN from adolescence to adulthood compared to term.

Methods

In a longitudinal cohort we measured BP at 3 visits in 220 adolescents born preterm with very low birth weight and 52 born term (mean age 14.4 yr). 148 preterm and 35 term subjects returned as adults (mean age 19.7 yr) and had BP measured at 2 visits. We defined high BP ≥120/80 and HTN ≥130/80 mmHg. We compared high BP and HTN prevalence in preterm vs. term in adolescents and adults with Fisher’s exact test and calculated risk ratios with log-binomial regression. We calculated the change in BP/yr in preterm vs. term with linear mixed models. We calculated incident rate ratios comparing number of high BP or HTN measurements per person-yr from adolescence to adulthood in preterm vs. term with Poisson regression. All models were adjusted for race, HTN pregnancy, and birth weight z-score.

Results

Mean follow up was 5.5 yr (range 3.6-9.1). Preterm subjects had significantly higher systolic BP as adolescents and adults vs. term (mean difference 2.5 and 4.6 mmHg, respectively). In adolescents, the preterm vs. term high BP prevalence was 2% vs. 0% (ns); no participants had HTN. In adults, the preterm vs. term prevalence of high BP was 13% vs. 3% (p=0.14) and HTN 9% vs 3% (ns). Preterm subjects had 4.4x increased risk of high BP as adults vs. term (0.6-31.6); this was attenuated after adjustment. The preterm-term difference in change in systolic BP was 0.3 mmHg/yr (95% CI -0.2 to 0.8); this was attenuated after adjustment. Preterm subjects had a 3.1x increased adjusted rate of high BP per person-yr (1.3-7.0) and a 2.7x increased adjusted rate of HTN per person-yr (0.9-7.5) from adolescence to adulthood vs. term.

Conclusion

Individuals born preterm had increased BP as adolescents and adults and increased rates of high BP and HTN from adolescence to adulthood compared to term-born peers. Early detection and treatment is important in this at-risk population.

Funding

  • Other NIH Support