Early Life determinants of Blood pressure patterns in young Adults (ELBA Study). (360G-Wellcome-086676_Z_08_Z)

Adolescents with high blood pressure (BP) are at increased risk of hypertension and cardiovascular disease (CVD) as adults. The early life factors responsible for increased BP in youth are not well understood, partly because maternal characteristics and early childhood growth patterns have not been properly characterised, and partly because brachial BP overestimates central blood pressure, does not encompass variations in 24 hour BP or BP responses to stressors. We propose to measure brachial an d central BP, and dynamic BP responses in the whole ALSPAC birth cohort at age 17 (n=8000), and undertake more detailed measurements in a 2500 subsample, including 24 hour central and brachial BP monitoring, wave reflection, arterial stiffness, carotid intima-media thickness, and left ventricular mass. We will relate detailed early life growth trajectories, fat distribution and maternal determinants to these measures of BP, and in turn relate measures of BP to the subclinical CVD outcomes of ca rotid intima media thickness, arterial stiffness (pulse wave velocity) and left ventricular mass. This study represents a unique opportunity to assess the importance of early life exposures from birth into adolescence on blood pressure and will provide novel insights into the mechanisms of the association between growth, obesity and blood pressure.