Birth measurements, family history, and environmental factors associated with later-life hypertensive status.
BACKGROUND
This birth cohort study was conducted to investigate the contribution of prenatal and antenatal environmental exposures to later-life hypertensive status.


METHODS
Two thousand five hundred and three individuals born in 1921-1954 at the Peking Union Medical College Hospital (PUMCH) were targeted; 2,081 (83.1%) participated. Clinical examinations included an interview, blood pressure (BP) measurements, and laboratory assays. Statistical analyses were performed using ordinal regression models with later-life hypertensive status as the dependent variable. Similar analyses were for subpopulations divided by family history of hypertension.


RESULTS
In the 2,081 subjects, 449 were normotensive, 531 were prehypertensive, and 1,101 had hypertension. Three hundred and forty two hypertensive patients were classified as high-risk (BP ≥180/110 mm Hg, or accompanied with diabetes or three well-established cardiovascular risk factors); the other 759 patients were at mid-to-low risks. Lower birth weight (<2,500 g: odds ratio (OR) = 1.67, P = 0.02; 2,500- <3,000 g: OR = 1.64, P < 0.01; 3,000- <3,500 g, OR = 1.40, P = 0.01), family history of hypertension (OR = 1.73, P < 0.01), poor education (OR = 1.76, P < 0.01), and alcoholism (OR = 3.05, P < 0.01) significantly predicted later-life high-risk hypertension. For participants with hypertensive family history (57.7%), the association with birth weight became nonsignificant, but poor education (OR = 2.33, P < 0.01) and alcoholism (OR = 3.10, P = 0.01) remained important. For participants without hypertensive family history (42.3%), the effects of lower birth weight (<2,500 g: OR = 2.26, P = 0.02; 2,500- <3,000 g: OR = 1.91, P = 0.01; 3,000- <3,500 g, OR = 1.78, P = 0.01) and alcoholism (OR = 3.23, P < 0.01) remained significant.


CONCLUSIONS
Low birth weight, low education, alcoholism, and hypertensive family history are linked to later-life hypertensive status. Low birth weight is also partly associated with one's genetic background; whereas the association with education and alcoholism are independent from hypertensive family history.
Clinical Pharmacological Research Center, Peking Union Medical College Hospital, Academy of Chinese Medical Sciences, Beijing, China.
Xia
X
Chen
Zhen-Xin
ZX
Zhang
Linda K
LK
George
Zi-Shi
ZS
Wang
Zhong-Jie
ZJ
Fan
Tao
T
Xu
Xiao-Lin
XL
Zhou
Shao-Mei
SM
Han
Hong-Bo
HB
Wen
Yi
Y
Zeng
D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000150:complications; D044466:Asian People; D001724:Birth Weight; D001794:Blood Pressure / Q000235:genetics / Q000502:physiology; D001827:Body Height; D002318:Cardiovascular Diseases / Q000209:etiology; D004522:Educational Status; D005192:Family Health; D005260:Female; D006801:Humans; D006973:Hypertension / Q000235:genetics / Q000503:physiopathology*; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012307:Risk Factors