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We examined whether longitudinal patterns of BMI development in childhood are associated with HTN across adult ages. We included 124 670 children (51% boys), born between 1960\u20131996, from the Copenhagen School Health Records Register with height and weight measurements at ages 6\u201315 years. Latent class trajectory models were used to identify five sex-specific BMI trajectories: below-average, average, above-average, overweight, and obesity. Individuals were followed from age 25 in national health registers from 1995\u20132022 for HTN. Cox models were used to estimate sex-specific hazard ratios (HRs) with 95% confidence intervals (CIs) for HTN across childhood BMI trajectories, with adjustment for birth cohort and parental education. Follow-up was split into ages 25\u201339, 40\u201349, and 50\u201362 years. Over a median 18-year follow-up, 5 970 men (9.4%) and 5 712 women (9.3%) developed HTN. Men and women with above-average, overweight, and obesity childhood BMI trajectories had higher hazards of HTN than those with the average trajectory. Associations attenuated with age but remained significant. Compared to men with the average trajectory, the obesity trajectory was associated with a HR\u2009=\u20094.31 (95% CI: 3.45\u20135.37) at ages 25\u201339 and HR\u2009=\u20092.12 (1.63\u20132.76) at ages 50\u201362 years. Compared to women with the average trajectory, the obesity trajectory was associated with a HR\u2009=\u20093.53 (2.89\u20134.30) at ages 25\u201339 and HR\u2009=\u20092.19 (1.70\u20132.82) at ages 50\u201362 years. Childhood BMI trajectories are positively associated with adult HTN in a dose\u2212response manner highlighting the potential value of early obesity prevention.<\/jats:p>","DOI":"10.1038\/s41371-026-01219-5","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T17:36:07Z","timestamp":1788543367000},"page":"895-902","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Childhood BMI trajectories and hypertension in adulthood: a population-based cohort study"],"prefix":"10.1038","volume":"40","author":[{"given":"Dominique","family":"Searle","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth Wreford","family":"Andersen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Aarestrup","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9649-6615","authenticated-orcid":false,"given":"Jennifer L.","family":"Baker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"key":"1219_CR1","doi-asserted-by":"publisher","first-page":"1273","DOI":"10.1056\/NEJMoa2206916","volume":"389","author":"The Global Cardiovascular Risk Consortium","year":"2023","unstructured":"The Global Cardiovascular Risk Consortium. 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Unrelated to this work JLB has consulted for Novo Nordisk with all fees paid to her institute.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"This study was conducted in accordance with the Declaration of Helsinki. The processing of data for this study was approved by the Danish Data Protection Agency (P-2019\u2013832).","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"Under Danish law, informed consent is not required for register-based research using pre-existing data. Therefore, individual informed consent was not obtained for this study.","order":3,"name":"Ethics","label":"Consent to participate","group":{"name":"EthicsHeading","label":"Ethics"}}]}}