Published Online
on December 5, 2005

A more recent version of this article appeared on January 1, 2006

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Submitted on September 20, 2005
Revised on October 11, 2005

Early Socioeconomic Position and Blood Pressure in Childhood and Adulthood. The Cardiovascular Risk in Young Finns Study

Mika Kivimäki^*; Debbie A. Lawlor; George Davey Smith; Liisa Keltikangas-Järvinen; Marko Elovainio; Jussi Vahtera; Laura Pulkki-Råback; Leena Taittonen; Jorma S.A. Viikari; and Olli T. Raitakari

From the Department of Psychology (M.K., L.K.-J., M.E., L.P.-R.), University of Helsinki, Finland; Department of Social Medicine (D.A.L., G.D.S.), University of Bristol, United Kingdom; Department of Pediatrics (L.T.), University of Oulu, and Central Hospital of Vaasa, Finland; Department of Pediatrics (J.S.A.V.), University of Turku, Finland; Department of Medicine and Department of Clinical Physiology (O.T.R.), University of Turku, Finland; and Finnish Institute of Occupational Health (M.K., J.V.), Helsinki, Finland.

^* To whom correspondence should be addressed. E-mail: mika.kivimaki{at}ttl.fi.

Abstract--Studies have found an association between low socioeconomic position in childhood and high adult blood pressure. It is unclear whether this association is explained by a pathway directly linking disadvantage to elevated blood pressure in childhood and adolescence, which then tracks into adulthood. We assessed parental socioeconomic position and systolic blood pressure in 1807 children and adolescents ages 3 to 18 years at baseline. Adult systolic blood pressure was measured 21 years later at ages 24 to 39 years. There was strong tracking of blood pressure from childhood to adulthood. Lower parental socioeconomic position was associated with higher blood pressure in childhood, adolescence (P<0.01), and adulthood (P<0.0001), with the mean age- and sex-adjusted systolic pressure differences between the highest and lowest socioeconomic groups varying between 2.9 and 4.3 mm Hg. With adjustment for blood pressure in childhood and adolescence, the regression coefficient between parental socioeconomic position and adult blood pressure attenuated by 32%. A similar level of attenuation (28%) occurred with adjustment for adult body mass index (BMI). With adjustment for both preadult blood pressure and adult BMI, the association between parental socioeconomic position and adult blood pressure was attenuated by 45%. Other factors, including birth weight and BMI in childhood and adolescence, had little impact on the association between parental socioeconomic position and adult blood pressure. These data suggest that early socioeconomic disadvantage influences later blood pressure in part through an effect on blood pressure in early life, which tracks into adulthood, and in part through an effect on BMI.

Key words: blood pressure • socioeconomic factors • life style • epidemiology

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