HONOLULU — Children who perceive the world in hostile ways are significantly more likely to have hypertension, according to a study of almost 900 children.
A style of interaction marked by hostility has long been known to be a risk factor for hypertension in adults, but with this study Dr. Désirée Seeyave of the University of Michigan, Ann Arbor, and her colleagues extended that observation to children as young as 9 years old.
Among 873 children, those who scored in the highest tertile of hostility were 13.5 times more likely to have a diastolic blood pressure at or above the 90th percentile than were children in the lowest tertile, after the investigators controlled for race, gender, maternal education, and body mass index z score, Dr. Seeyave reported at the annual meeting of the Pediatric Academic Societies.
The children were enrolled in the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development. When they were in the third, fourth, and fifth grades, investigators administered the Intent Attributions and Feelings of Distress Scale, Hostile Intent Instrumental Provocation Score.
This instrument assesses to what extent a child ascribes hostile intent to ambiguous situations. For example, the child is asked to imagine a scenario in which he or she lets another child play with a radio that then gets broken. The interviewer will ask why the other child broke the toy and whether he or she was trying to be mean. The child will score high on hostile attribution if he or she assumes that the other child broke the toy intentionally in an effort to be mean.
A year later, when the children were in the fourth, fifth, and sixth grades, investigators measured blood pressure by standard protocols. In the multivariate analysis, the investigators found no significant associations between high blood pressure and gender, race, or mother's education. Children whose BMIs were above average for their age were 3.8 times more likely to have diastolic blood pressure in the 90th percentile or above than were children whose BMIs were normal for their age.
These findings have implications for prevention of cardiovascular disease risk factors such as hostility and obesity beginning in childhood, the investigators wrote.
Dr. Seeyave stated that she had no conflicts of interest related to her presentation.