Childhood hypertension linked to elevated long-term risk of major adverse cardiac events

Children with hypertension have a higher likelihood of experiencing major adverse cardiac events (MACEs) for the next 13 years compared with their healthy counterparts, as reported in a study.

The study included 25,605 children with hypertension (median age 15 years, 57.6 percent boys) and 128,025 matched controls without hypertension. The matching was performed based on age, sex, birth weight, maternal gestational hypertension, prior comorbidities (chronic kidney disease, diabetes, cardiovascular surgery), and a propensity score for hypertension.

The primary outcome of MACE was defined as a composite of cardiovascular death, stroke, hospitalization for myocardial infarction or unstable angina, and coronary intervention. Kaplan-Meier method and Cox proportional hazards regression were used in the analyses.

Baseline covariates in the hypertension and control groups were balanced, and prior comorbidities were infrequent (malignancy: 5.7 percent vs 6.2 percent; congenital heart disease: 4.3 percent vs 4.2 percent; diabetes: 1.9 percent vs 1.9 percent).

Over a median follow-up of 13.6 years, MACE occurred more frequently in the hypertension group than in the control group (incidence rate, 4.6 vs 2.2 per 1,000 person-years). Childhood hypertension was associated with a twofold higher long-term risk of incident MACE (hazard ratio, 2.1, 95 percent CI, 1.9–2.2).

Compared with controls, children with hypertension had a greater risk of stroke, hospitalization for myocardial infarction or unstable angina, coronary intervention, and congestive heart failure but not cardiovascular death.