Marika Kaakinen1, Ulla Sovio2, Anna-Liisa Hartikainen3, Anneli Pouta4, Markku J Savolainen5, Karl-Heinz Herzig6, Paul Elliott7, Bianca De Stavola8, Esa Läärä9, Marjo-Riitta Järvelin10. 1. Institute of Health Sciences, University of Oulu, Oulu, Finland Biocenter Oulu, Oulu, Finland Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK. 2. Department of Obstetrics & Gynaecology, University of Cambridge, Cambridge, UK. 3. Institute of Clinical Medicine/Obstetrics and Gynaecology, University of Oulu, Oulu, Finland Medical Research Center, Oulu University Hospital, Oulu, Finland. 4. Institute of Clinical Medicine/Obstetrics and Gynaecology, University of Oulu, Oulu, Finland Medical Research Center, Oulu University Hospital, Oulu, Finland Department of Children and Young People and Families, National Institute for Health and Welfare, Oulu, Finland. 5. Biocenter Oulu, Oulu, Finland Medical Research Center, Oulu University Hospital, Oulu, Finland Institute of Clinical Medicine/Internal Medicine, University of Oulu, Oulu, Finland. 6. Biocenter Oulu, Oulu, Finland Medical Research Center, Oulu University Hospital, Oulu, Finland Institute of Biomedicine/Physiology, University of Oulu, Oulu, Finland. 7. Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK. 8. Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK. 9. Department of Mathematical Sciences, University of Oulu, Oulu, Finland. 10. Institute of Health Sciences, University of Oulu, Oulu, Finland Biocenter Oulu, Oulu, Finland Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK Department of Children and Young People and Families, National Institute for Health and Welfare, Oulu, Finland Unit of Primary Care, Oulu University Hospital, Oulu, Finland.
Abstract
BACKGROUND: Fetal and postnatal growth have been associated with adult blood pressure (BP), but findings about the relative importance of growth at different stages of life on BP are inconsistent. METHODS: The study population comprised 5198 participants from the Northern Finland Birth Cohort 1966 with data on birth weight, height and weight measurements until adolescence, systolic and diastolic BP at 31 years and several covariates. Structural equation modelling was used in the analysis. RESULTS: Negative direct effects of birth weight on adult systolic BP were observed (standardised regression coefficients: -0.08 (-0.14 to -0.03) in males and -0.04 (-0.09 to 0.01) in females, equalling -1.99 (-3.32 to -0.65) and -1.01 (-2.33 to 0.32) mm Hg/kg, respectively). Immediate postnatal growth was associated with adult BP only indirectly via growth later in life. In contrast, growth from adiposity rebound onwards had large direct, indirect and total effects on adult BP. Current body mass index was the strongest growth-related predictor of adult BP (0.36 (0.30 to 0.41) in males and 0.31 (0.24, 0.37) in females, equalling 1.29 (1.09 to 1.48) and 0.81 (0.63 to 0.99) mm Hg/(kg/m(2)), respectively). CONCLUSIONS: Our path analytical approach provides evidence for the importance of both fetal growth and postnatal growth, especially from adiposity rebound onwards, in determining adult BP, together with genetic predisposition and behavioural factors. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
BACKGROUND: Fetal and postnatal growth have been associated with adult blood pressure (BP), but findings about the relative importance of growth at different stages of life on BP are inconsistent. METHODS: The study population comprised 5198 participants from the Northern Finland Birth Cohort 1966 with data on birth weight, height and weight measurements until adolescence, systolic and diastolic BP at 31 years and several covariates. Structural equation modelling was used in the analysis. RESULTS: Negative direct effects of birth weight on adult systolic BP were observed (standardised regression coefficients: -0.08 (-0.14 to -0.03) in males and -0.04 (-0.09 to 0.01) in females, equalling -1.99 (-3.32 to -0.65) and -1.01 (-2.33 to 0.32) mm Hg/kg, respectively). Immediate postnatal growth was associated with adult BP only indirectly via growth later in life. In contrast, growth from adiposity rebound onwards had large direct, indirect and total effects on adult BP. Current body mass index was the strongest growth-related predictor of adult BP (0.36 (0.30 to 0.41) in males and 0.31 (0.24, 0.37) in females, equalling 1.29 (1.09 to 1.48) and 0.81 (0.63 to 0.99) mm Hg/(kg/m(2)), respectively). CONCLUSIONS: Our path analytical approach provides evidence for the importance of both fetal growth and postnatal growth, especially from adiposity rebound onwards, in determining adult BP, together with genetic predisposition and behavioural factors. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Entities:
Keywords:
BLOOD PRESSURE; Epidemiological methods; GROWTH; Life course epidemiology
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