Childhood Blood-Pressure History and Adult Fasting Glucose: Insights from the Bogalusa Heart Study

Abstract

Lifecourse research indicates that cardiovascular risk begins early, yet the relationship between pediatric blood pressure (BP) trajectories and adult glycemia is incompletely characterized. We present a focused synthesis of longitudinal evidence, with emphasis on cohorts such as the Bogalusa Heart Study, to examine whether childhood elevated BP predicts fasting blood glucose (FBG) in adulthood. Across studies, persistent high BP from childhood through adolescence is associated with later insulin resistance and modest elevations in FBG, independent of adiposity. Putative mechanisms include shared genetic architecture, early endothelial dysfunction, and lifestyle clustering (low fitness, high sodium intake). We discuss analytic considerations—tracking vs. trajectory modeling, time-varying confounding, and mediation by adult BMI—and propose a harmonized framework for future analyses. Prevention strategies combining school-based BP screening, diet quality improvement, and structured physical activity may confer dual benefit for vascular and glycemic outcomes. Standardized reporting of pediatric BP z-scores and adult glycemic endpoints will improve comparability and meta-analytic power.