Risk of hypertension into adulthood in persons born prematurely : A national cohort study
(2020) In European Heart Journal 41(16). p.1542-1550- Abstract
Aims: Preterm birth has been associated with elevated blood pressure early in life; however, hypertension risks from childhood into adulthood remain unclear. We conducted a large population-based study to examine gestational age at birth in relation to hypertension risks from childhood into adulthood. Methods and results: A national cohort study was conducted of all 4 193 069 singleton live births in Sweden during 1973-2014, who were followed up for hypertension identified from nationwide inpatient and outpatient (specialty and primary care) diagnoses from any health care encounters through 2015 (maximum age 43 years; median 22.5). Cox regression was used to examine gestational age at birth in relation to hypertension risk while... (More)
Aims: Preterm birth has been associated with elevated blood pressure early in life; however, hypertension risks from childhood into adulthood remain unclear. We conducted a large population-based study to examine gestational age at birth in relation to hypertension risks from childhood into adulthood. Methods and results: A national cohort study was conducted of all 4 193 069 singleton live births in Sweden during 1973-2014, who were followed up for hypertension identified from nationwide inpatient and outpatient (specialty and primary care) diagnoses from any health care encounters through 2015 (maximum age 43 years; median 22.5). Cox regression was used to examine gestational age at birth in relation to hypertension risk while adjusting for other perinatal and maternal factors, and co-sibling analyses assessed the potential influence of unmeasured shared familial (genetic and/or environmental) factors. In 86.8 million person-years of follow-up, 62 424 (1.5%) persons were identified with hypertension (median age 29.8 years at diagnosis). Adjusted hazard ratios for new-onset hypertension at ages 18-29 years associated with preterm (<37 weeks) and extremely preterm (22-27 weeks) birth were 1.28 [95% confidence interval (CI), 1.21-1.36] and 2.45 (1.82-3.31), respectively, and at ages 30-43 years were 1.25 (1.18-1.31) and 1.68 (1.12-2.53), respectively, compared with full-Term birth (39-41 weeks). These associations affected males and females similarly and appeared substantially related to shared genetic or environmental factors in families. Conclusions: In this large national cohort, preterm birth was associated with increased risk of hypertension into early adulthood. Persons born prematurely may need early preventive evaluation and long-Term monitoring for the development of hypertension.
(Less)
- author
- Crump, Casey LU ; Sundquist, Jan LU and Sundquist, Kristina LU
- organization
- publishing date
- 2020
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Adult, Blood pressure, Gestational age, Hypertension, Premature birth, Preterm birth
- in
- European Heart Journal
- volume
- 41
- issue
- 16
- pages
- 9 pages
- publisher
- Oxford University Press
- external identifiers
-
- scopus:85083913153
- pmid:31872206
- ISSN
- 0195-668X
- DOI
- 10.1093/eurheartj/ehz904
- language
- English
- LU publication?
- yes
- id
- cb3663ae-9e3a-42f0-b91a-53a5c593ab54
- date added to LUP
- 2020-05-20 09:21:01
- date last changed
- 2024-04-17 08:45:21
@article{cb3663ae-9e3a-42f0-b91a-53a5c593ab54,
abstract = {{<p>Aims: Preterm birth has been associated with elevated blood pressure early in life; however, hypertension risks from childhood into adulthood remain unclear. We conducted a large population-based study to examine gestational age at birth in relation to hypertension risks from childhood into adulthood. Methods and results: A national cohort study was conducted of all 4 193 069 singleton live births in Sweden during 1973-2014, who were followed up for hypertension identified from nationwide inpatient and outpatient (specialty and primary care) diagnoses from any health care encounters through 2015 (maximum age 43 years; median 22.5). Cox regression was used to examine gestational age at birth in relation to hypertension risk while adjusting for other perinatal and maternal factors, and co-sibling analyses assessed the potential influence of unmeasured shared familial (genetic and/or environmental) factors. In 86.8 million person-years of follow-up, 62 424 (1.5%) persons were identified with hypertension (median age 29.8 years at diagnosis). Adjusted hazard ratios for new-onset hypertension at ages 18-29 years associated with preterm (<37 weeks) and extremely preterm (22-27 weeks) birth were 1.28 [95% confidence interval (CI), 1.21-1.36] and 2.45 (1.82-3.31), respectively, and at ages 30-43 years were 1.25 (1.18-1.31) and 1.68 (1.12-2.53), respectively, compared with full-Term birth (39-41 weeks). These associations affected males and females similarly and appeared substantially related to shared genetic or environmental factors in families. Conclusions: In this large national cohort, preterm birth was associated with increased risk of hypertension into early adulthood. Persons born prematurely may need early preventive evaluation and long-Term monitoring for the development of hypertension.</p>}},
author = {{Crump, Casey and Sundquist, Jan and Sundquist, Kristina}},
issn = {{0195-668X}},
keywords = {{Adult; Blood pressure; Gestational age; Hypertension; Premature birth; Preterm birth}},
language = {{eng}},
number = {{16}},
pages = {{1542--1550}},
publisher = {{Oxford University Press}},
series = {{European Heart Journal}},
title = {{Risk of hypertension into adulthood in persons born prematurely : A national cohort study}},
url = {{http://dx.doi.org/10.1093/eurheartj/ehz904}},
doi = {{10.1093/eurheartj/ehz904}},
volume = {{41}},
year = {{2020}},
}