Long-Term Time in Target Range for Systolic Blood Pressure Since Childhood and Midlife Arterial Stiffness
Yang Wang, MD, PhD,
Han Qi, PhD,
Hao Jia, MD,
Dan Wang, MD,
Yue Sun, MD,
Bo-Wen Zhang, MPH,
Ming-Fei Du, MD,
Gui-Lin Hu, MD,
Zi-Yue Man, MD,
Chao Chu, MD, PhD,
Xiao-Jun Yang, MPH,
Teng Zhang, MD,
Tong-Shuai Guo, MD,
Xi Zhang, MD,
Yu Yan, MD,
Zheng Liu, PhD,
Ming-Ke Chang, MD,
Hao Li, MD,
Fang-Yao Chen, PhD,
Yu-Ming Kang, PhD,
Jie Ren, MD,
Zu-Yi Yuan, MD, PhD,
Ling Zhang, PhD,
Jian-Jun Mu, MD
Affiliations
Yang Wang, MD, PhD
Department of Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
Han Qi, PhD
Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders and National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
Hao Jia, MD
Department of Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
Dan Wang, MD
Department of Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
Yue Sun, MD
Department of Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
Bo-Wen Zhang, MPH
Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
Ming-Fei Du, MD
Department of Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
Gui-Lin Hu, MD
Department of Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
Zi-Yue Man, MD
Department of Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
Chao Chu, MD, PhD
Department of Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
Xiao-Jun Yang, MPH
Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
Teng Zhang, MD
Department of Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
Tong-Shuai Guo, MD
Department of Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
Xi Zhang, MD
Department of Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
Yu Yan, MD
Department of Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
Zheng Liu, PhD
Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
Ming-Ke Chang, MD
Department of Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
Hao Li, MD
Department of Critical Care Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
Fang-Yao Chen, PhD
Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, China
Yu-Ming Kang, PhD
Department of Physiology and Pathophysiology, Xi’an Jiaotong University School of Basic Medical Sciences, Shaanxi Engineering and Research Center of Vaccine, Key Laboratory of Environment and Genes Related to Diseases of Education Ministry of China, China
Jie Ren, MD
Department of Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
Zu-Yi Yuan, MD, PhD
Department of Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
Ling Zhang, PhD
Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China; Address for correspondence: Prof Ling Zhang, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, 10 Xitoutiao, Youanmenwai, Beijing 100069, China.
Jian-Jun Mu, MD
Department of Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China; Prof Jian-Jun Mu, Department of Cardiovascular Medicine, First Affiliated Hospital of Xian Jiaotong University, 277 Yanta West Road, Xi’an 710061, China.
Background: Elevated blood pressure (BP) in childhood is associated with adult hypertension and arterial stiffness. However, the effect of long-term time in target range (TTR) for BP since childhood on the risk of arterial stiffness in midlife remains unclear. Objectives: The purpose of this study was to determine the independent association of TTR for systolic blood pressure (SBP) from childhood to midlife with arterial stiffness in adulthood. Methods: This study used data from the ongoing cohort of the Hanzhong Adolescent Hypertension Study. SBP-TTR was assessed over 36 years, with the target ranges of SBP defined as the 90th to 95th percentile of SBP for age, sex, and height in childhood, and 110 to 130 mm Hg in adulthood. Arterial stiffness was defined as brachial-ankle pulse wave velocity >1,400 cm/s. Results: Of the total 1,959 participants, 55.5% (1,088 of 1,959) were men, and the mean age was 49 years. The risk of arterial stiffness exhibited a gradual decrease with increasing SBP-TTR over the 36-year follow-up. Compared with the participants in the lowest quartile of SBP-TTR from childhood to midlife, those in the highest quartile showed significantly reduced arterial stiffness risk in midlife. This association persisted even after adjusting for mean SBP and SBP variability. Furthermore, men in the highest quartile of SBP-TTR demonstrated a markedly lower arterial stiffness risk than those in the lowest quartile, whereas this effect was not observed in women. Conclusions: Higher long-term SBP-TTR from childhood to midlife is associated with a reduced risk of arterial stiffness in midlife, regardless of the mean SBP or SBP variability.
