{"id":"46007","type":"article","url":"https://hartvaat.nl/2026/04/30/hanzhong-cohort-36-jaar-follow-up-snelle-bloeddrukstijging-in-kindertijd-voorspe/","title":"Hanzhong-cohort (36 jaar follow-up): snelle bloeddrukstijging in kindertijd voorspelt orgaanschade in middelbare leeftijd","title_en":"Blood Pressure Change and Subclinical Target Organ Damage in Mid-Adulthood","category":"hypertensie","category_label":"Hypertensie","professions":["cardioloog","huisarts","internist"],"tags":[],"journal":"Hypertension","doi":"https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26364","source_url":"https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26364","authors":["Tongshuai Guo"],"significance":7,"published":"2026-07-11","source_date":"2026-04-30","image":"","kennis":["https://hartvaat.nl/kennis/preventie/levenslang-cardiovasculair-risico/","https://hartvaat.nl/kennis/hypertensie/bloeddrukmeting-thuismeting-abpm/"],"congress":"","summary_en":"Cohort study within the Hanzhong Adolescent Hypertension Study in 2,508 participants with ≥4 BP measurements between 1987 and 2023. Growth models constructed age-specific BP levels and rates of change (slopes) and related them to subclinical end-organ damage in mid-adulthood (arterial stiffness, left ventricular hypertrophy, albuminuria). Rates of change at each age point were positively associated with arterial stiffness and albuminuria, independent of BP level itself. The associations rose from childhood, peaked in adolescence, and declined thereafter: per 1 SD increase in systolic BP rate of change, the OR for arterial stiffness was 1.94 at age 6, 2.11 at age 13, and fell to 1.13 by age 52. In childhood and adolescence, the rate of BP increase was more important than the concurrent level; from young adulthood onwards this reversed. Similar patterns for LVH. Early monitoring of the pace of BP rise — not only the level — may therefore be essential for cardiovascular prevention.","created":"2026-07-03T20:27:04Z","updated":"2026-07-04T19:27:06Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Cohortstudie binnen het Hanzhong Adolescent Hypertension Study bij 2.508 deelnemers met ≥4 bloeddrukmetingen tussen 1987 en 2023. Met groei-modellen werden leeftijdsspecifieke bloeddrukniveaus en veranderingssnelheden (slopes) geconstrueerd en gerelateerd aan subklinische eindorgaanschade in middelbare leeftijd (arteriële stijfheid, linkerventrikelhypertrofie, albuminurie). Veranderingssnelheid op elk leeftijdspunt was positief geassocieerd met arteriële stijfheid en albuminurie, onafhankelijk van het bloeddrukniveau zelf. De associaties stegen vanaf de kindertijd, piekten in de adolescentie en daalden daarna: per 1 SD-toename in systolische BD-veranderingssnelheid was de OR voor arteriële stijfheid 1,94 op 6-jarige leeftijd, 2,11 op 13-jarige leeftijd, en daalde naar 1,13 op 52-jarige leeftijd. In kindertijd en adolescentie was de snelheid van bloeddrukstijging belangrijker dan het concomitante niveau; vanaf jonge volwassenheid keerde dit om. Vergelijkbare patronen voor LVH. Vroege monitoring van het tempo van bloeddrukstijging — niet alleen het niveau — kan dus essentieel zijn voor cardiovasculaire preventie.","abstract_original":"BACKGROUND:Blood pressure (BP) is a dynamic trait associated with cardiovascular disease. We aimed to estimate age-specific BP levels and rates of change from childhood to mid-adulthood and to examine their associations with subsequent subclinical target organ damage.METHODS:We included 2508 participants from the Hanzhong Adolescent Hypertension Study with BP measured ≥4× from 1987 to 2023. Surrogate markers of target organ damage were assessed, including arterial stiffness, left ventricular hypertrophy, and albuminuria. Growth models were used to construct BP trajectories and estimate age-specific BP levels and rates of change (slopes).RESULTS:Rates of change in BP at each age point from childhood to mid-adulthood were positively associated with arterial stiffness and albuminuria in mid-adulthood, independent of corresponding BP levels. The magnitude of the associations rose from childhood, peaked in adolescence, and declined thereafter. For example, odds ratios (95% CIs) per 1 SD increase in systolic BP change rates for arterial stiffness increased from 1.94 (1.69–2.24) at age 6 to 2.11 (1.82–2.44) at age 13, then declined to 1.13 (1.01–1.28) by age 52. Faster BP increases were more strongly associated with arterial stiffness and albuminuria than concurrent BP levels during childhood and adolescence, whereas the opposite trend was observed in young and mid-adulthood. Similar age-dependent trends were identified for left ventricular hypertrophy, with minor variations in the ages at which associations reached statistical significance.CONCLUSIONS:Accelerated BP increases during childhood and adolescence show a stronger association with mid-adult subclinical target organ damage than increases occurring in adulthood."}