Published online before print February 10, 2003, doi: 10.1161/01.HYP.0000054212.23528.B2
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(Hypertension. 2003;41:451.)
© 2003 American Heart Association, Inc.
Scientific Contributions |
Rapid Child Growth Raises Blood Pressure in Adolescent Boys Who Were Thin at Birth
From the Department of Nutrition, University of North Carolina at Chapel Hill (L.S.A.) and the Centre for Paediatric Epidemiology and Biostatistics, Institute of Child Health (T.J.C.), London, UK.
Correspondence to Linda S. Adair, PhD, Carolina Population Center, University of North Carolina, 123 W Franklin St, Chapel Hill, NC 27516-3997. E-mail linda_adair{at}unc.edu
Catch-up growth in previously growth-restricted children is a suggested risk factor for chronic disease risk. We use data from 2026 Filipino adolescents to identify periods of growth that matter more for risk of high blood pressure (BP). Subjects were drawn from the Cebu Longitudinal Health and Nutrition Survey, which enrolled pregnant women and followed up their offspring through age14 to 16 years. High BP was defined as the top 10% of residuals from gender-specific regressions of systolic and diastolic BP on age and height. After controlling for birth length, current body mass index, age, and height, the odds of high BP in males were significantly decreased with each kilogram increase in birth weight. The highest odds of elevated BP occurred among males who were relatively thin at birth but relatively heavy as adolescents. Larger weight increments from birth to 2 years decreased the odds of high BP in boys, whereas larger increments from 8 to 11 and 11 to 16 years increased the odds of high BP. Thinness at birth significantly interacted with growth rate after age 8, such that a high rate of weight gain increased risk only among boys who were in the lower two thirds of the body mass index distribution at birth. Results in girls indicated small or no effects of early growth. The synergistic effect on adolescent BP of rapid weight gain from late childhood into adolescence with thinness at birth is further evidence of fetal programming of BP in males and suggests long-term health risks associated with rapid growth, even in the absence of obesity.
Key Words: birth weight • blood pressure • child growth • infant nutrition • adolescents
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