Abstract
OBJECTIVE—To determine whether reduced fetal growth leads to raised blood pressure, reduced arterial compliance, and increased left ventricular mass in an Indian population. DESIGN—A retrospective cohort study of men and women (age range 40-61 years) whose weight, length, and head circumference at birth were recorded. SETTING—The Holdsworth Memorial Hospital, Mysore, South India. SUBJECTS—435 men and women born in the hospital between 1934 and 1953. MAIN OUTCOME MEASURES—Systolic and diastolic blood pressures; compliance in four arterial segments derived from pulse wave velocity, measured by a non-invasive optical method; and left ventricular mass measured using M mode echocardiography. RESULTS—Small size at birth was not associated with increased adult blood pressure or left ventricular mass, or with reduced arterial compliance. Systolic blood pressure and left ventricular mass were higher in subjects who were greater in length at birth, rising by 1.64 mm Hg (95% confidence interval (CI) −0.08 to +3.37 mm Hg) and 1.63 g/m2 (95% CI 0.13 to 3.13 g/m2), respectively, per one inch (2.5 cm) increase in birth length, independently of adult size. Arterial compliance was reduced in people whose mothers were lighter and had smaller pelvic (external conjugate) diameters. CONCLUSIONS—The higher prevalence of coronary heart disease in Indian men and women of lower birth weight, shown in an earlier study of the same cohort, cannot be explained by changes in blood pressure, arterial compliance, and left ventricular mass. The association of raised blood pressure and left ventricular mass with longer birth length suggests that the way in which the intrauterine environment influences coronary heart disease differs between Indian and Western populations. Keywords: birth size; blood pressure; arterial compliance; left ventricular mass
Full Text
The Full Text of this article is available as a PDF (134.4 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Barker D. J. Fetal origins of coronary heart disease. BMJ. 1995 Jul 15;311(6998):171–174. doi: 10.1136/bmj.311.6998.171. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Barker D. J., Godfrey K. M., Osmond C., Bull A. The relation of fetal length, ponderal index and head circumference to blood pressure and the risk of hypertension in adult life. Paediatr Perinat Epidemiol. 1992 Jan;6(1):35–44. doi: 10.1111/j.1365-3016.1992.tb00741.x. [DOI] [PubMed] [Google Scholar]
- Barker D. J., Martyn C. N., Osmond C., Hales C. N., Fall C. H. Growth in utero and serum cholesterol concentrations in adult life. BMJ. 1993 Dec 11;307(6918):1524–1527. doi: 10.1136/bmj.307.6918.1524. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Beegom R., Beegom R., Niaz M. A., Singh R. B. Diet, central obesity and prevalence of hypertension in the urban population of south India. Int J Cardiol. 1995 Sep;51(2):183–191. doi: 10.1016/0167-5273(95)02402-i. [DOI] [PubMed] [Google Scholar]
- Chadha S. L., Radhakrishnan S., Ramachandran K., Kaul U., Gopinath N. Epidemiological study of coronary heart disease in urban population of Delhi. Indian J Med Res. 1990 Dec;92:424–430. [PubMed] [Google Scholar]
- Devereux R. B., Alonso D. R., Lutas E. M., Gottlieb G. J., Campo E., Sachs I., Reichek N. Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Am J Cardiol. 1986 Feb 15;57(6):450–458. doi: 10.1016/0002-9149(86)90771-x. [DOI] [PubMed] [Google Scholar]
- Forsén T., Eriksson J. G., Tuomilehto J., Teramo K., Osmond C., Barker D. J. Mother's weight in pregnancy and coronary heart disease in a cohort of Finnish men: follow up study. BMJ. 1997 Oct 4;315(7112):837–840. doi: 10.1136/bmj.315.7112.837. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hales C. N., Barker D. J., Clark P. M., Cox L. J., Fall C., Osmond C., Winter P. D. Fetal and infant growth and impaired glucose tolerance at age 64. BMJ. 1991 Oct 26;303(6809):1019–1022. doi: 10.1136/bmj.303.6809.1019. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Law C. M., Barker D. J., Bull A. R., Osmond C. Maternal and fetal influences on blood pressure. Arch Dis Child. 1991 Nov;66(11):1291–1295. doi: 10.1136/adc.66.11.1291. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Law C. M., Shiell A. W. Is blood pressure inversely related to birth weight? The strength of evidence from a systematic review of the literature. J Hypertens. 1996 Aug;14(8):935–941. [PubMed] [Google Scholar]
- Leon D. A., Koupilova I., Lithell H. O., Berglund L., Mohsen R., Vagero D., Lithell U. B., McKeigue P. M. Failure to realise growth potential in utero and adult obesity in relation to blood pressure in 50 year old Swedish men. BMJ. 1996 Feb 17;312(7028):401–406. doi: 10.1136/bmj.312.7028.401. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Levy D., Savage D. D., Garrison R. J., Anderson K. M., Kannel W. B., Castelli W. P. Echocardiographic criteria for left ventricular hypertrophy: the Framingham Heart Study. Am J Cardiol. 1987 Apr 15;59(9):956–960. doi: 10.1016/0002-9149(87)91133-7. [DOI] [PubMed] [Google Scholar]
- Lindroos M., Kupari M., Heikkilä J., Tilvis R. Echocardiographic evidence of left ventricular hypertrophy in a general aged population. Am J Cardiol. 1994 Aug 15;74(4):385–390. doi: 10.1016/0002-9149(94)90408-1. [DOI] [PubMed] [Google Scholar]
- Martyn C. N., Barker D. J., Jespersen S., Greenwald S., Osmond C., Berry C. Growth in utero, adult blood pressure, and arterial compliance. Br Heart J. 1995 Feb;73(2):116–121. doi: 10.1136/hrt.73.2.116. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Murthy N. K., Gemson K. Observations on the epidemiology of coronary heart disease from an industrial hospital. Trop Doct. 1980 Jul;10(3):103–105. doi: 10.1177/004947558001000305. [DOI] [PubMed] [Google Scholar]
- Osmond C., Barker D. J., Winter P. D., Fall C. H., Simmonds S. J. Early growth and death from cardiovascular disease in women. BMJ. 1993 Dec 11;307(6918):1519–1524. doi: 10.1136/bmj.307.6918.1519. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ounsted M. K., Cockburn J. M., Moar V. A., Redman C. W. Factors associated with the blood pressures of children born to women who were hypertensive during pregnancy. Arch Dis Child. 1985 Jul;60(7):631–635. doi: 10.1136/adc.60.7.631. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Phillips D. I., Barker D. J., Hales C. N., Hirst S., Osmond C. Thinness at birth and insulin resistance in adult life. Diabetologia. 1994 Feb;37(2):150–154. doi: 10.1007/s001250050086. [DOI] [PubMed] [Google Scholar]
- Ramachandran A., Snehalatha C., Latha E., Vijay V., Viswanathan M. Rising prevalence of NIDDM in an urban population in India. Diabetologia. 1997 Feb;40(2):232–237. doi: 10.1007/s001250050668. [DOI] [PubMed] [Google Scholar]
- Rich-Edwards J. W., Stampfer M. J., Manson J. E., Rosner B., Hankinson S. E., Colditz G. A., Willett W. C., Hennekens C. H. Birth weight and risk of cardiovascular disease in a cohort of women followed up since 1976. BMJ. 1997 Aug 16;315(7105):396–400. doi: 10.1136/bmj.315.7105.396. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sahn D. J., DeMaria A., Kisslo J., Weyman A. Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements. Circulation. 1978 Dec;58(6):1072–1083. doi: 10.1161/01.cir.58.6.1072. [DOI] [PubMed] [Google Scholar]
- Stein C. E., Fall C. H., Kumaran K., Osmond C., Cox V., Barker D. J. Fetal growth and coronary heart disease in south India. Lancet. 1996 Nov 9;348(9037):1269–1273. doi: 10.1016/s0140-6736(96)04547-3. [DOI] [PubMed] [Google Scholar]
- Vijayakumar M., Fall C. H., Osmond C., Barker D. J. Birth weight, weight at one year, and left ventricular mass in adult life. Br Heart J. 1995 Apr;73(4):363–367. doi: 10.1136/hrt.73.4.363. [DOI] [PMC free article] [PubMed] [Google Scholar]