Abstract 15557: Altered Cardiovascular Phenotype in Young Adults Born Premature: A 25-Year Prospective Follow-Up Study
Background - Premature birth is a risk factor for increased blood pressure (BP) in young adulthood, though the underlying mechanisms are incompletely understood. We thus studied in detail the impact of being born preterm on long-term changes in cardiovascular structure and function.
Methods - We performed a prospective follow-up study of 101 preterm-born individuals from birth (birth weight±SD=1312.11±333.61 grams; mean gestational age±SD=30.36±2.71 weeks) through to young adulthood (mean age±SD = 25.09±1.34 years). A group of 58 age and sex-matched normal birth weight (NBW) term-born individuals were recruited as controls. Peripheral BP and tonometry-based central BP and carotid-femoral pulse wave velocity (cfPWV) were measured, and left ventricular (LV) mass assessed using cardiovascular magnetic resonance imaging (CMR).
Results - Individuals born premature had significantly elevated peripheral and central BP (P<0.05), with the greatest increase in central systolic BP (107.57±9.80 vs 97.16±8.54 mmHg, P<0.0001). Preterm-born young adults also had significantly higher cfPWV (5.83±0.80 vs 5.42±0.58 m/s, P=0.001) and LV mass indexed to body surface area (LVMI, 62.36±10.16 vs 55.34±11.31 g/m2, P=0.0001) compared to term born controls. LVMI and cfPWV were positively related (r=0.174, P=0.040 ), and were both significantly associated with central systolic BP (r=0.264, P=0.001 and r=0.271, P=0.001, respectively).
Conclusions - Preterm-born young adults have elevated peripheral BP, with even more pronounced differences in central BP parameters. We have shown for the first time that, in addition to increased arterial stiffness, preterm-born individuals already have significantly greater LVMI in young adulthood compared to NBW term-born controls. As the proportion of preterm-born survivors continues to rise, further understanding of cardiovascular changes in these individuals will be important for developing targeted prevention strategies to reduce their long-term risk of cardiovascular disease.
- © 2011 by American Heart Association, Inc.