Initiation of hypertension in utero and its amplification throughout life.
OBJECTIVE
To determine whether the relation between high blood pressure and low birth weight is initiated in utero or during infancy, and whether it changes with age.


METHODS
A longitudinal study of children and three follow up studies of adults.


METHODS
Farnborough, Preston, and Hertfordshire, England, and a national sample in Britain.


METHODS
1895 children aged 0-10 years, 3240 men and women aged 36 years, 459 men and women aged 46-54 years, and 1231 men and women aged 59-71 years. The birth weight of all subjects had been recorded.


METHODS
Systolic blood pressure.


RESULTS
At all ages beyond infancy people who had lower birth weight had higher systolic blood pressure. Systolic blood pressure was not related to growth during infancy independently of birth weight. The relation between systolic pressure and birth weight became larger with increasing age so that, after current body mass was allowed for, systolic pressure at ages 64-71 years decreased by 5.2 mm Hg (95% confidence interval 1.8 to 8.6) for every kg increase in birth weight.


CONCLUSIONS
Essential hypertension is initiated in fetal life. A raised blood pressure is then amplified from infancy to old age, perhaps by a positive feedback mechanism.
Law
C M
CM
MRC Environmental Epidemiology Unit, Southampton General Hospital.
de Swiet
M
M
Osmond
C
C
Fayers
P M
PM
Barker
D J
DJ
Cruddas
A M
AM
Fall
C H
CH
D000328:Adult; D000368:Aged; D000375:Aging; D001724:Birth Weight; D001794:Blood Pressure; D015992:Body Mass Index; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D015331:Cohort Studies; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology*; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D015430:Weight Gain