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The impact of folic acid/VB12 deficiency on essential hypertension in children and adolescents: from a nested case-control and a cohort study

Journal of Human Hypertension volume 38, pages 844–850 (2024)Cite this article

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Abstract

To explore the relationship between serum folic acid (FA) or Vitamin B12 (VB12) and elevated BP in children and adolescents. Both a nested case control and a cohort study were designed to explore the relationship between serum folic acid (FA) or Vitamin B12 (VB12) and elevated blood pressure (BP). All the included participants were from primary school. A total of 326 subjects (116:210) in nested case control were from an established cohort. And 270 participants without hypertension at baseline and followed in 2019 in cohort. FA and VB12 levels were lower in the elevated BP group than in the control group, and homocysteine level was higher than that in the control group. In the elevated BP group, overweight/obese children had lower FA than overweight/obese children in the normal BP group. FA was positively correlated with high-density lipoprotein (HDL) and Apo lipoprotein A (APOA), but negatively correlated with triglyceride (TG). FA was significantly correlated with elevated BP in children and adolescents (β = –0.353, P = 0.032), after adjusting VB12, and homocysteine (HCY), and the interaction effect of FA*HCY was significant. Both systolic and diastolic BP levels were statistically lower in the FA high exposure group than in the FA low exposure group in the cohort study. This study found that FA and vitamin B12 deficiency in childhood was correlated with elevated BP levels, which may affect BP by regulating lipid levels, and confirmed the importance of maintaining high levels of FA and vitamin B12 in childhood either by diet or supplementation.

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Data availability

Data are available from Xiaohua Liang (contact via xiaohualiang@hospital.cqmu.edu.cn, or liangxiaohua666@sina.com).

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Acknowledgements

We would like to acknowledge the laboratory support of the Ministry of Education Key Laboratory of Child Development and Disorders and all of the staff members of the 6 elementary schools in the two regions.

Funding

This work was supported by the Project of Chongqing Science and Technology Bureau (No. CSTB2023NSCQ-MSX0181, No.CSTC2021jscx-gksb-N0001), the Natural Science Foundation Project (No. 82373590), the National Clinical Research Center for Child Health and Disorders (NCRCCHD-2022-GP-01), Program for Youth Innovation in Future Medicine from Chongqing Medical University (No.W0088), National key research and development project (No.2017YFC0211705), Intelligent Medicine Project (No.ZHYX202109). The funders had no role in the whole study research process, including study design, the data collection, and analysis, the decision to publish, or the preparation of the manuscript.

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Author notes

  1. These authors contributed equally: Xiaohua Liang, Daochao Huang.

Authors and Affiliations

  1. Department of Clinical Epidemiology and Biostatistics, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases, Key Laboratory of Children’s Important Organ Development and Diseases of Chongqing Municipal Health Commission, Chongqing, 400016, China

    Xiaohua Liang, Daochao Huang, Yang Bi, Yun He, Taoyu Mao, Qin Liu, Jishuang Tong, Lan Chen, Xizou An, Xiaoping Jiang & Muhammad Fahad Tahir

  2. University of Illinois Chicago, 1200 West Harrison St, Chicago, IL, 60607, USA

    Taoyu Mao

  3. The Second Department of pediatrics, The First People’s Hospital of Nanyang City, Nanyang, Henan, People’s Republic of China

    Guomin Hu

  4. Department of Laboratory Medicine, Laboratory for Diagnosis and Treatment of Infectious Diseases Integrated Traditional Chinese and Western Medicine, Chongqing Traditional Chinese Medicine Hospital, Chongqing, China

    Yuwei Wang

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Contributions

XH: Conceptualization, Methodology, Writing—Review & Editing; DC: Revision, Writing—Review & Editing; YB: Investigation, Supervision; YH: Investigation, Supervision; TY: Revision, Investigation, Supervision; QL: Investigation, Supervision; GM: Investigation, Supervision; JS: Investigation, Supervision; LC: Validation, Resources; YW: Validation, Resources; XZ: Writing—Original Draft, Review & Editing; XP: Review & Editing; MF: Review & Editing.

Corresponding author

Correspondence to Xiaohua Liang.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

The Institutional Review Board at the Children’s Hospital of Chongqing Medical University gave its approval for the study. Informed consent to participate in this study was provided by all of the children and their parents/guardians.

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All authors critically reviewed and approved the publication of the final paper.

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Liang, X., Huang, D., Bi, Y. et al. The impact of folic acid/VB12 deficiency on essential hypertension in children and adolescents: from a nested case-control and a cohort study. J Hum Hypertens 38, 844–850 (2024). https://doi.org/10.1038/s41371-024-00955-w

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