Hypertension Clinical Trial
To investigate the relationship of birth weight and childhood blood pressure.
BACKGROUND:
Cardiovascular diseases are the leading causes of morbidity and mortality in the United
States. On the basis of an interplay of genetic and environmental factors, these diseases
appear to be rooted in childhood. Recent reports implicate the intrauterine nutritional
environment regulating fetal growth as a determinant of adult cardiovascular disease.
According to this concept, impaired fetal growth, with consequent lower birth weight,
results in alteration in organ structure and subsequent functional impairment in later life.
Higher blood pressure (BP) has been suggested as the possible link between compromised
intrauterine growth and the long-term risk for cardiovascular disease. Despite the many
reports which appear to support the low birth weight - high BP hypothesis, this concept is
in conflict with the body of data on the association of BP with body size in childhood,
adolescence, and adulthood which consistently demonstrates a direct relationship between
body weight and BP.
The results of this prospective study contributed an objective body of data to this
important issue. If birth measures reflecting intrauterine exposure do contribute
significantly to BP in later childhood, then studies focused on the mechanisms regulating
this risk are justified. Alternatively, if post-natal/childhood parameters are the major
determinants of later BP, then efforts should focus on effective preventive strategies in
childhood, such as obesity.
DESIGN NARRATIVE:
To examine the low birth weight - high blood pressure concept, the investigators conducted a
prospective study on a cohort of children who were well characterized at birth. In 1988,
data on weight, length, BP, gestation and maternal health were obtained on 1,160 newborn
cases representing a range of birth weight and gestational age. They re-examined these
children at age 11-13 years to test the overall hypothesis that birth weight, as well as
other newborn measures of intrauterine growth, did not correlate with BP at age 11-13 years.
The aims of the project were to: 1) determine if birth weight contributed to BP and/or body
size in childhood; 2) determine if the duration of intrauterine growth in terms of
gestational age contributed to BP and body size; 3) determine if newborn ponderal index, a
measure of relative fetal growth, contributed to BP and body size; and 4) determine the
relative contribution of newborn measures of birth weight, gestational age, BP, ponderal
index, and maternal health to BP and body size in late childhood.
The study completion date listed in this record was obtained from the "End Date" entered in
the Protocol Registration and Results System (PRS) record.
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