Published online before print September 2, 2008, doi: 10.1161/HYPERTENSIONAHA.108.115485
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(Hypertension. 2008;52:613.)
© 2008 American Heart Association, Inc.
Editorial Commentaries |
Slow Prenatal Growth and Accelerated Postnatal Growth
Critical Influences on Adult Blood Pressure
From the Department of Physiology, University of Mississippi Medical Center, Jackson.
Correspondence to Barbara T. Alexander, Department of Physiology, University of Mississippi Medical Center, 2500 North State St, Jackson, MS 39216-4505. E-mail balexander@physiology.umsmed.edu
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
It is well established that birth weight has a significant and inverse relationship with systolic blood pressure.1 Rapid weight gain in early infancy after slow fetal growth promotes higher blood pressure and increased cardiovascular risk in later life.2,3 Accelerated weight gain during childhood also enhances the risk of elevated blood pressure associated with low birth weight.4 However, the exact contribution of weight gain during "distinct" periods of early life on later blood pressure and whether accelerated postnatal growth independent of birth weight is critical to a later increase in blood pressure remain unclear. In the current issue of Hypertension, Ben-Shlomo et al5 used multiple measures of growth from birth to 5 years with an approach that modeled changes in growth velocity rather than anthropometry in relation to adult blood pressure. Use of this approach to model growth trajectories allowed them to investigate the inherent complexities of discrete periods of early growth on later blood pressure. In this study they demonstrated that rapid increases in postnatal weight in the first 6 months of life were critical to elevated adult systolic and diastolic blood pressure.5 Importantly, this finding was independent of fetal growth. In addition, an inverse association between birth weight and blood pressure was noted, and weight gain in childhood was positively associated with systolic blood pressure. Although several studies have noted an inverse relationship between birth weight and diastolic blood pressure,4,6 the prediction of diastolic blood pressure by immediate postnatal weight gain is novel.5 An increase in diastolic blood
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