TOPLINE:

Higher blood pressure (BP) at birth and in early childhood, which was tracked consistently through preschool and school age, was associated with a significantly increased risk for elevated BP and hypertension later in childhood. Notably, higher mean arterial pressure at birth or preschool age was linked to an approximately threefold higher risk of developing hypertension later.

METHODOLOGY:

• Researchers conducted a prospective cohort study to examine BP trajectories from birth through childhood and to evaluate whether BP at birth and in early childhood is associated with the risk for elevated BP and hypertension later in childhood.
• They included 500 healthy children from a Belgian birth cohort who had two or more BP measurements across follow-up visits, of whom 283 had BP measured at birth and preschool age (4-6 years), 272 had BP measured at preschool and school age (9-11 years), and 55 had BP measured at three timepoints (birth, preschool age, and school age) between 2010 and 2024.
• At preschool and school age, BP was measured using an automated upper arm-based BP monitor following the European Society of Hypertension guidelines.
• BP was tracked by evaluating changes in mean arterial pressure (calculated as diastolic BP plus 40% of pulse pressure) percentiles from birth to preschool age and from preschool age to school age.

TAKEAWAY:

• Mean systolic BP, diastolic BP, and arterial pressures increased from birth (67.3, 40.5, and 51.2 mm Hg, respectively) to preschool age (100.2, 57.5, and 74.6 mm Hg, respectively) and increased further to school age (107.7, 65.1, and 82.1 mm Hg, respectively).
• Among children who were followed up from birth to preschool age, each 1 SD increase in BP at birth was associated with an increase in systolic BP by 1.97 mm Hg and mean arterial pressure by 1.83 mm Hg (P < .05 for both); however, no significant increase in diastolic BP was observed after adjustments.
• From the preschool to school age, each 1 SD rise in BP was associated with an increase in systolic BP by 3.94 mm Hg and mean arterial pressure by 2.37 mm Hg (P < .05 for both), although no significant increase in diastolic BP was observed. However, children who were followed up at all three timepoints had a significant increase in systolic BP, diastolic BP, and mean arterial pressure with each 1 SD rise in BP (P < .05 for all).
• Each 1 SD increase in the initial mean arterial pressure at birth or preschool age was associated with a 2.84-fold higher risk for elevated BP (hazard ratio [HR], 2.84; P = .001) and a 3.75-fold increased risk for hypertension (HR, 3.75; P < .001) in later childhood.

IN PRACTICE:

"Our study underscores the importance of a life course approach to BP management, suggesting that a deeper understanding of BP trajectory and early development of cardiovascular risk is essential for timely identification and prevention of nonoptimal BP in childhood," the authors wrote.

SOURCE:

This study was led by Yu-Ling Yu, MD, PhD, Research Unit Environment and Health, KU Leuven Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium. It was published online on January 13, 2026, in JAMA Network Open.

LIMITATIONS:

Measuring diastolic BP in young children was challenging, especially due to the very small vessel size of neonates. This study was limited by the relatively small number of children with data from birth through the school age. The relatively high prevalence of elevated BP was observed, in line with previous findings.

DISCLOSURES:

This study was supported by a postdoctoral grant from the Research Foundation Flanders. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.