Early life determinants of adult blood pressure.
OBJECTIVE
While treating high blood pressure in middle age is beneficial in terms of reducing the occurrence of cardiovascular disease, treated and well controlled hypertensive adults still have a substantial excess mortality and reduced survival compared with normotensives. Therefore, identification of the means of preventing hypertension in earlier life is an important objective. There is increasing evidence that adult blood pressure is determined by a range of characteristics from the intrauterine period, through infancy and childhood. The purpose of this review is to provide a summary of the current evidence concerning the early life determinants of adult blood pressure.


RESULTS
Children from poorer socioeconomic positions, those whose mothers experience pregnancy-induced hypertension, those whose mothers smoke throughout pregnancy, those with low birthweight, who are not breast-fed, who have high sodium diets in infancy and who are obese in childhood or adolescence tend to have higher blood pressure in adulthood. However, the mechanisms linking these early life factors to later blood pressure and the most appropriate means of preventing adult hypertension by intervening in early life are unclear.


CONCLUSIONS
There is clear evidence that early life factors are important determinants of adult blood pressure. However, there is a need for randomized trials with sufficient resources for long-term follow-up to assess the effects that interventions such as preventing pregnancy-induced hypertension, reducing maternal smoking, increasing breast-feeding, reducing salt consumption in infancy and preventing childhood obesity have on adult blood pressure and cardiovascular disease.
Lawlor
Debbie A
DA
Department of Social Medicine, University of Bristol, Bristol, UK.
Smith
George Davey
GD
D000328:Adult; D000367:Age Factors; D001724:Birth Weight / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology*; D001942:Breast Feeding; D002648:Child; D002657:Child Development / Q000502:physiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology*; D007223:Infant; D009043:Motor Activity / Q000502:physiology; D009765:Obesity / Q000150:complications; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D012959:Socioeconomic Factors; D012982:Sodium, Dietary / Q000009:adverse effects
D012982:Sodium, Dietary