Research has also
shown that cardiometabolic risk factors in mothers is associated with higher
blood pressure in offspring.
‘Early cardiometabolic risk assessment and intervention with folate before conception and during pregnancy may offer new ways to prevent high blood pressure and its long-term consequences in the offsprings.’
The prevalence
of childhood elevated blood pressure has increased in the United States since
1980s, in particular among African Americans.
High blood pressure during childhood is a
strong predictor of higher blood pressure later in life, and people with higher
blood pressure are at greater risk of developing cardiovascular, metabolic and
kidney disease and stroke.
Childhood Hypertension
There is no
specific value for pediatric or
childhood hypertension as it does not have a specifically assigned number.
A child is
considered hypertensive when the systolic or the diastolic blood pressure is
more than or equal to 95th percentile of children of the same age, sex and
height for more than 3 consecutive readings.
A value of more
than 120/80 mm of Hg is usually considered significant. In pre-hypertension,
the blood pressure values are between the 90th percentile and 95th percentile.
Since it is
difficult to manage hypertension, diabetes and cardiovascular disease in
adults, it is always better to identify early life risk factors for the
prevention of such conditions; it can also be a cost-effective public health
strategy.
Folate during
Pregnancy
Maternal
nutrition during pregnancy may influence offspring
cardiometabolic health through its impact on the fetal intrauterine
environment.
Folate, is
a B-vitamin that is present in various food sources. Folate is
involved in processes like nucleic acid synthesis, gene
expression, and cellular growth.
Folic acid is a form of folate,
which is found in various food sources like citrus juices and
dark green vegetables. Folic acid is necessary for production of new,
healthy cells in the body.
In young adults,
higher folic acid intake has been associated with a lower incidence of
hypertension later in life.
Pregnant women are advised to
consume 400 micrograms of
folic acid supplements daily. It is essential to
prevent important birth defects in the baby's brain and spine.
Until the
current study, no prospective birth cohort has examined the role of maternal
folate levels, alone or in combination with maternal cardiometabolic risk
factors on child blood pressure.
Study
For the study,
researchers analyzed the data from a prospective United States urban birth
cohort, that comprised mainly low-income racial and ethnic minorities, who were
at a high risk for elevated blood pressure.
They wanted to
examine the individual and joint effect of maternal folic acid levels and
cardiometabolic risk factors on offspring blood pressure.
Researchers
included 1290 mother-child pairs, 67.8% of whom were Black and 19.2% of whom
were Hispanic. They were recruited at birth and followed up to 9 years of age
from 2003 to 2014 at the Boston Medical Center.
Around 38.2% of
the mothers had one or more cardiometabolic risk factors:
- 14.6% had hypertensive disorders
- 11.1% had diabetes
- 25.1% had pre-pregnancy obesity
A total of 28.7%
of children had elevated systolic blood pressure at age 3-9 years.
Children with
higher systolic blood pressure were more likely to have mothers with
pre-pregnancy obesity, hypertensive disorders, and diabetes.
Children with
elevated systolic blood pressure were also more likely to have:
- lower birth weight
- lower gestational age
- higher BMI
Findings:
The study
findings suggest that higher levels of maternal folic acid help offset the
adverse effect of maternal cardiometabolic risk factors on child systolic blood
pressure.
Mothers who had
any cardiometabolic risk factors but had folic acid levels above the median
level gave birth to children who had 40% lower odds of elevated childhood
systolic blood pressure.
"Our study
adds further evidence on the early life origins of high blood pressure,"
said Dr. Xiaobin Wang, the study's senior corresponding author. "Our
findings raise the possibility that early risk assessment and intervention
before conception and during pregnancy may lead to new ways to prevent high
blood pressure and its consequences across lifespan and generations."
The new article
is published in the
American Journal of Hypertension.
Hypertension in Children-Statistics
In U.S during
2003-2006, the prevalence of pre-hypertension among
children and adolescents aged 8-17 years was approximately 14% in boys and 6%
in girls.
The prevalence of hypertension in
childhood is about 4-5% and is slightly more common in
the male child.
During
1997-2006, hospitalization rates for children and adolescents with a diagnosis
of hypertension went up from approximately 18 cases per 100,000 pediatric
hospital discharges in 1997 to approximately 35 cases per 100,000 in 2006.
A study in South
India found that the prevalence of pre-hypertension and hypertension was
similar in urban (2.9% and 2.8%) and rural (2.8% and 2%) school children in the
age group of 10 to 16 years.
References :- Xiaobin Wang et al. Association of Maternal Plasma Folate and Cardiometabolic Risk Factors in Pregnancy with Elevated Blood Pressure of Offspring in Childhood. American Journal of Hypertension; (year) DOI Link
- Hypertension in Childhood - (http://patient.info/in/doctor/hypertension-in-childhood)
- Hypertension Screening in Children and Adolescents — National Ambulatory Medical Care Survey, National Hospital Ambulatory Medical Care Survey, and Medical Expenditure Panel Survey, United States, 2007-2010 - (https://www.cdc.gov/mmwr/preview/mmwrhtml/su6302a8.htm)
- Pediatric Hypertension (High Blood Pressure in Children) - (//www.medindia.net/patientinfo/pediatric-hypertension.htm)
- Folate - (https://ods.od.nih.gov/factsheets/Folate-Consumer/)
Source: Medindia
