Clinical trial NCT00005421: Blood Pressure Tracking--Childhood to Young Adulthood
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Cardiovascular Diseases
Heart Diseases
Hypertension
Lead sponsor: National Heart, Lung, and Blood Institute (NHLBI)
Sponsor class: NIH
First posted: 2000-05-26
Sex: MALE
Maximum age (years): 100
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no

Brief summary: To extend analyses of blood pressure (BP) tracking to a period that spanned childhood and young adulthood. Data were used from the same cohort of 339 children who had been followed for nine to twelve years in a previous study.

Detailed description: BACKGROUND:

Blood pressure measurements in childhood and young adulthood are less predictive of future levels than those taken in middle age. In part, this may be due to the fact that within-person variability appears to make up a larger proportion of total variability in childhood than adulthood. Previous work on an NHLBI supported grant indicated that repeated blood pressure measurements and visits led to higher childhood tracking correlations over a period of three years.

DESIGN NARRATIVE:

Follow-up data were used as well as multiple visits which reduced the large within-person variability of blood pressure measurements and improved the tracking correlations. In addition, 'true' or 'corrected' tracking correlations were provided by eliminating the effects of random measurement error. The effects were examined of time-varying covariates on both the observed and true tracking correlations. Besides computing tracking correlations, predictive values were computed for young adult blood pressure given childhood levels. This was the probability that a young adult's true blood pressure was above a specific cutpoint conditional on childhood blood pressure. These values were validated using data from the Fels Longitudinal Study, which included serial blood pressure measurements over the age range in the study. The prediction models were also derived including terms for covariates such as age, sex, height and weight. From these models nomograms were constructed which were useful to physicians for prognostic purposes. Thus, because of the unique multiple-visit approach used in these data, the effect of random measurement error was eliminated. These methodologic improvements strengthened the usefulness of blood pressure screening in childhood to detect those at high risk of developing hypertension.

The study completion date listed in this record was obtained from the "End Date" entered in the Protocol Registration and Results System (PRS) record.

Eligibility criteria: No eligibility criteria

Primary outcomes:
Secondary outcomes:
Other outcomes:
Locations:
Study officials:
affiliation: Brigham and Women's Hospital
name: Nancy Cook
References:
citation: Cook NR, Gillman MW, Rosner BA, Taylor JO, Hennekens CH. Prediction of young adult blood pressure from childhood blood pressure, height, and weight. J Clin Epidemiol. 1997 May;50(5):571-9. doi: 10.1016/s0895-4356(97)00046-2.
citation: Cook NR. Estimating predictive values for blood pressure measurements from multivariate regression models with covariates. Stat Med. 1996 Oct 15;15(19):2013-28. doi: 10.1002/(SICI)1097-0258(19961015)15:193.0.CO;2-Y.
citation: Gillman MW, Cook NR. Blood pressure measurement in childhood epidemiological studies. Circulation. 1995 Aug 15;92(4):1049-57. doi: 10.1161/01.cir.92.4.1049.
citation: Cook NR, Cohen J, Hebert PR, Taylor JO, Hennekens CH. Implications of small reductions in diastolic blood pressure for primary prevention. Arch Intern Med. 1995 Apr 10;155(7):701-9.
citation: Gillman MW, Cook NR, Rosner B, Evans DA, Keough ME, Taylor JO, Hennekens CH. Identifying children at high risk for the development of essential hypertension. J Pediatr. 1993 Jun;122(6):837-46. doi: 10.1016/s0022-3476(09)90005-1.