Abstract P204: Joint Association Between Birth Weight At Term And Later Life Adherence To A Healthy Lifestyle With Risk Of Hypertension
Objective: to prospectively assesse the joint association between birth weight and established lifestyle risk factors in adulthood with incident hypertension, and to quantity decompose the attributing effects to birth weight only, to adulthood lifestyle only and to their interaction.
Methods: We followed 52,114 women from the Nurses' Health Study II without hypercholesterolemia, diabetes, cardiovascular disease, cancer, prehypertension and hypertension at baseline (1991-2011). Women born preterm, of a multiple pregnancy, or who were missing birth weight data were excluded. Unhealthy adulthood lifestyle was defined by compiling status scores of body mass index (BMI), physical activity, alcohol consumption, the Dietary Approaches to Stop Hypertension (DASH) diet, and the use of nonnarcotic analgesics.
Results: We documented 12,588 incident cases of hypertension during 20 years of follow-up. The risk of hypertension associated with a combination of low birth weight at term and unhealthy lifestyle factors (RR 1.95; 95%CI: 1.83-2.07) was more than the addition of the risk associated with each individual factor, indicating a significant interaction on an additive scale (Pinteraction<0.001). The proportions of the association attributable to lower term birth weight alone, unhealthy lifestyle alone, and their joint effect were 23.9% (95%CI: 16.6-31.2), 63.7% (95%CI: 60.4-66.9), and 12.5% (95%CI: 9.87-15.0), respectively. Compared to the rest of the cohort, women with a birth weight at term ≥2.5kg and all the five healthy lifestyle factors had a multivariable-RR of 0.34 (95%CI: 0.26 to 0.43) for hypertension; and the PAR% of hypertension for not being in this group was 66.2% (95%CI: 56.9-73.8).
Conclusion: Our findings suggest that a combination of a healthy birth weight and a healthy adulthood lifestyle could prevent 66% of the cases of hypertension in this population, and the combined effects of lower birth weight at term and unhealthy lifestyle with the risk of hypertension are greater than additive.
Author Disclosures: Y. Li: None. S.H. Ley: None. T.J. VanderWeele: None. G.C. Curhan: None. J.W. Rich-Edwards: None. W.C. Walter: None. J.P. Forman: None. F.B. Hu: None. L. Qi: None.
- © 2015 by American Heart Association, Inc.