Circulation. 2002;105:1088-1092
Published online before print February 4, 2002, doi: 10.1161/hc0902.104677
Published online before print February 4, 2002, doi: 10.1161/hc0902.104677
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(Circulation. 2002;105:1088.)
© 2002 American Heart Association, Inc.
Clinical Investigation and Reports |
Fetal, Infant, and Childhood Growth and Adult Blood Pressure
A Longitudinal Study From Birth to 22 Years of Age
From the MRC Environmental Epidemiology Unit (C.M.L., A.W.S., C.A.N., H.E.S., C.N.M.), University of Southampton, Southampton General Hospital, Southampton; Royal Brompton Hospital (E.A.S.), London; Department of Public Health (P.M.F.), University of Aberdeen; and Institute of Reproductive and Developmental Biology (M.d.S.), Queen Charlotte’s and Chelsea Hospital, London, United Kingdom.
Correspondence to Dr Catherine Law, MRC Environmental Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK. E-mail claw{at}mrc.soton.ac.uk
Background— People who are small at birth tend to have higher blood pressure in later life. However, it is not clear whether it is fetal growth restriction or the accelerated postnatal growth that often follows it that leads to higher blood pressure.
Methods and Results— We studied blood pressure in 346 British men and women aged 22 years whose size had been measured at birth and for the first 10 years of life. Their childhood growth was characterized using a conditional method that, free from the effect of regression to the mean, estimated catch-up growth. People who had been small at birth but who gained weight rapidly during early childhood (1 to 5 years) had the highest adult blood pressures. Systolic pressure increased by 1.3 mm Hg (95% CI, 0.3 to 2.3) for every standard deviation score decrease in birth weight and, independently, increased by 1.6 mm Hg (95% CI, 0.6 to 2.7) for every standard deviation score increase in early childhood weight gain. Adjustment for adult body mass index attenuated the effect of early childhood weight gain but not of birth weight. Relationships were smaller for diastolic pressure. Weight gain in the first year of life did not influence adult blood pressure.
Conclusions— Part of the risk of adult hypertension is set in fetal life. Accelerated weight gain in early childhood adds to this risk, which is partly mediated through the prediction of adult fatness. The primary prevention of hypertension may depend on strategies that promote fetal growth and reduce childhood obesity.
Key Words: blood pressure • obesity • pediatrics • birth weight • prevention
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