Human growth and cardiovascular disease.

Low birthweight is now known to be associated with increased rates of coronary heart disease (CHD) and the related disorders, stroke, hypertension and type 2 diabetes. Associations between low birthweight and later disease have been extensively replicated in studies in different countries. They extend across the normal range of birthweight and depend on lower birthweights in relation to the duration of gestation rather than the effects of premature birth. The associations are thought to be consequences of developmental plasticity, the phenomenon by which one genotype can give rise to a range of different physiological or morphological states in response to different environmental conditions during development. Recent observations have shown that impaired growth in infancy and rapid childhood weight gain exacerbate the effects of impaired prenatal growth. CHD and the disorders related to it arise through a series of interactions between environmental influences and the pathways of growth and development that precede them.