BACKGROUND: Epidemiological studies have repeatedly shown inverse associations between size at birth and blood pressure in later life. There is some evidence to suggest that exaggerated blood pressure responses to psychological stressors are a forerunner of sustained hypertension. OBJECTIVE: To determine whether individuals who were smaller at birth have greater blood pressure and heart rate responses to psychological stressors. DESIGN: Prospective cohort study. METHODS: A total of 104 men and 79 women (mean age 26.3 years) were recruited from the Adelaide Family Heart Study cohort. Blood pressure was monitored continuously throughout the study using a Portapres and participants undertook a series of three stress tests: Stroop, mirror drawing and public speech. The stress response was defined as the increment from baseline to the mean blood pressure during the three tasks. RESULTS: In women, a 1 kg increase in birthweight was associated with an 8.7 mmHg (95% confidence interval: 3.6-13.8, P = 0.001) reduction in the systolic and a 4.1 mmHg (1.6-6.6, P = 0.002) reduction in the diastolic response to stress. The heart rate response to stress was also inversely related to birthweight. These results remained significant after correction for gestational age and other potential confounding factors. Similar results were found for birth length and head circumference. There were no such relationships in men. CONCLUSIONS: This study provides the first human evidence that cardiovascular responses to psychological stressors may be programmed antenatally and suggests a potential mechanism linking reduced fetal growth with raised blood pressure and cardiovascular disease in later life.
BACKGROUND: Epidemiological studies have repeatedly shown inverse associations between size at birth and blood pressure in later life. There is some evidence to suggest that exaggerated blood pressure responses to psychological stressors are a forerunner of sustained hypertension. OBJECTIVE: To determine whether individuals who were smaller at birth have greater blood pressure and heart rate responses to psychological stressors. DESIGN: Prospective cohort study. METHODS: A total of 104 men and 79 women (mean age 26.3 years) were recruited from the Adelaide Family Heart Study cohort. Blood pressure was monitored continuously throughout the study using a Portapres and participants undertook a series of three stress tests: Stroop, mirror drawing and public speech. The stress response was defined as the increment from baseline to the mean blood pressure during the three tasks. RESULTS: In women, a 1 kg increase in birthweight was associated with an 8.7 mmHg (95% confidence interval: 3.6-13.8, P = 0.001) reduction in the systolic and a 4.1 mmHg (1.6-6.6, P = 0.002) reduction in the diastolic response to stress. The heart rate response to stress was also inversely related to birthweight. These results remained significant after correction for gestational age and other potential confounding factors. Similar results were found for birth length and head circumference. There were no such relationships in men. CONCLUSIONS: This study provides the first human evidence that cardiovascular responses to psychological stressors may be programmed antenatally and suggests a potential mechanism linking reduced fetal growth with raised blood pressure and cardiovascular disease in later life.
Authors: Anderson H Kuo; Cun Li; Jinqi Li; Hillary F Huber; Peter W Nathanielsz; Geoffrey D Clarke Journal: J Physiol Date: 2016-12-17 Impact factor: 5.182
Authors: Wajid Aziz; Fernando S Schlindwein; Michael Wailoo; Taher Biala; Federico Cardona Rocha Journal: Clin Auton Res Date: 2011-11-02 Impact factor: 4.435
Authors: Alexander Jones; Alessandro Beda; Clive Osmond; Keith M Godfrey; David M Simpson; David I W Phillips Journal: Eur Heart J Date: 2008-07-22 Impact factor: 29.983
Authors: Laura A Cox; Michael Olivier; Kimberly Spradling-Reeves; Genesio M Karere; Anthony G Comuzzie; John L VandeBerg Journal: ILAR J Date: 2017-12-01