Identify Sensitive Periods for Onset and Resolution of Hypertension and Its Subtypes Over the Lifespan

Abstract

Hypertension represents a significant public health issue globally, yet the age-related changes in prevalence and transition patterns of blood pressure (BP) categories and hypertension subtypes throughout the lifespan remain unclear. This dynamic cohort study included 22 858 participants aged 3–80 years from the China Health and Nutrition Survey 1989–2015. Participants were categorized into eight sub-cohorts based on baseline age in 10-year intervals, i.e., 3–10, 11–20, 21–30, 31–40, 41–50, 51–60, 61–70, and 71–80 years. The study found that for participants with normal BP, the probabilities of developing hypertension over a 10-year follow-up period increased with age during adulthood, with the probabilities of developing systolic hypertension surpassing those of diastolic hypertension beginning at 41–50 years. In comparison, for participants with hypertension, the probabilities of reverting to normal BP generally decreased with age during adulthood, with those aged 11–20 years having the highest probabilities. The probabilities of maintaining hypertension showed contrasting age-related trends. These findings remained largely unchanged in additional analyses of adjustment for covariates, being restricted to a 20-year follow-up or being stratified by sex. In conclusion, individuals with normal BP are more likely to develop hypertension in late adulthood, whereas those with hypertension are more likely to revert to normal BP during adolescence. The age-related changes in prevalence and dynamic transition of hypertension over the lifespan underscore the necessity for developing age-appropriate prevention and intervention strategies.