ASSOCIATION OF LONG-TERM TIME IN TARGET RANGE FOR SYSTOLIC BLOOD PRESSURE SINCE CHILDHOOD WITH ARTERIAL STIFFNESS IN MIDLIFE: A 36-YEAR PROSPECTIVE COHORT STUDY

Objective: Elevated blood pressure (BP) in childhood is associated with adult hypertension and arterial stiffness. We aimed to determine the independent association of time in target range (TTR) for systolic blood pressure (SBP) from childhood to midlife with arterial stiffness in midlife. Design and method: Using data from the ongoing cohort of Hanzhong Adolescent Hypertension study, 1959 children and adolescents aged 6 to 18 years were enrolled at baseline. We assessed SBP-TTR from childhood to adulthood for 36 years, with the target range of SBP defined as 90th – 95th percentile for age, sex, and height in childhood, and 110 to 130 mmHg in adulthood. Arterial stiffness was measured by brachial-ankle pulse wave velocity. Results: During the 36 years of follow-up, the risk of arterial stiffness gradually decreased with increasing TTR for SBP. After full adjustment for traditional cardiovascular risk factors, comparing the highest vs. lowest quartiles of TTR for SBP, the odds ratios (ORs) [95% confidence intervals (CIs)] were 0.642 (0.452-0.911) for the risk of arterial stiffness in adulthood. TTR remained significantly associated with arterial stiffness despite adjustment for mean SBP or SBP variability. In addition, males with the highest quartile of SBP-TTR were significantly associated with a decreased risk of arterial stiffness {OR 95% CI, 0.432 (0.262-0.710)}, while no significant difference was found in females compared with the lowest TTR group. Conclusions: Higher long-term TTR for SBP from childhood to adulthood was associated with a decreased risk of arterial stiffness in adulthood independent of mean BP or BP variability. Therefore, SBP-TTR from an early age might serve as a modifiable risk factor for future cardiovascular diseases in later life.