Wang et al. Respond

We thank Pollack and Cheng for their interest in our work. First, we agree that there may have been some measurement errors and that those errors could have reduced the strength of the association estimates between higher trajectory groups and high blood pressure.¹ However, it is unlikely that they would have altered our conclusion that children with higher body mass index trajectories are at increased risk of high blood pressure during adolescence.

Second, the justification regarding the generalizability of our findings requires external data beyond the scope of a single study. Although Fan and Zhang used different groups than those included in our study,² their findings are consistent with ours: different childhood body mass index trajectories confer significantly different odds of elevated blood pressure, and, specifically, body mass index increases in childhood are significantly associated with an increased risk of high blood pressure later in life.

Finally, all of our analyses were conducted separately by gender, as there were disparities between the growth trajectories of male and female participants. We also adjusted for baseline age, baseline body mass index, baseline systolic blood pressure, and living area, which were the same variables adjusted for in Fan and Zhang’s study. Follow-up duration was not adjusted because there were no significant differences between the four trajectory groups.