Risk factor patterns and vascular health in children with incident hypertension: The ExAMIN Youth SA study.

Risk factor exposure during childhood contributes to the early onset of cardiovascular disease and clusters with incident hypertension. We investigated cardiovascular risk factor patterns in preadolescent children, stratified by BP status, and their associations with macro- and microvasculature measures. We included children (n = 1043, ages 5-9 years) from the ExAMIN Youth SA study. Measurements included anthropometry, cardiorespiratory fitness, dietary intake, office BP, central pulse wave velocity (PWV), central retinal artery (CRAE), vein equivalent (CRVE), and their ratio (AVR), to identify factor patterns with exploratory factor analysis. We identified three factor pattern scores (FPS). FPS1 (chips, sweets, fast foods, and cookies/cake) and FPS2 (fruits, meat, milk, and socioeconomic status) were identified in both the normotensive blood pressure (BP) and incident hypertension groups, with the exceptions of fruits being absent in the incident hypertension group and fast foods absent in the normotensive group. FPS3, characterised by BMI, diastolic BP, and systolic BP, was observed only in the normotensive group. PWV associated with FPS3 (β = 0.372, p < 0.001) in the normotensive but with FPS2 (β = 0.197, p = 0.045) in the incident hypertension group. CRAE (β = -0.224, p = 0.001) and AVR (β = -0.26, p < 0.001) inversely associated with FPS3 in normotensive but with FPS1 in the incident hypertension (CRAE: β = -0.343, p < 0.001; AVR: β = -0.274, p < 0.001). CRVE was positively associated with FPS3 (β = 0.194, p = 0.002) in the normotensive group. Exposure to unhealthy dietary patterns in childhood compromises vascular health in the context of incident hypertension, beginning as early as five years of age.