Clinical Pharmacological Research Center, Peking Union Medical College Hospital, Academy of Chinese Medical Sciences, Beijing, China.
Am J Hypertens. 2012 Apr;25(4):464-71. doi: 10.1038/ajh.2011.262. Epub 2012 Feb 2.
This birth cohort study was conducted to investigate the contribution of prenatal and antenatal environmental exposures to later-life hypertensive status.
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.
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.
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.
本队列研究旨在探讨产前和围产期环境暴露对晚年高血压状态的影响。
研究对象为 1921 年至 1954 年在北京协和医学院医院（PUMCH）出生的 2503 人，其中 2081 人（83.1%）参与了研究。临床检查包括访谈、血压测量和实验室检测。使用 ordinal 回归模型，以晚年高血压状态为因变量进行统计分析。对于按高血压家族史划分的亚人群也进行了类似的分析。
在 2081 名受试者中，449 人血压正常，531 人血压正常但偏高，1101 人患有高血压。342 名高血压患者被归类为高危（血压≥180/110mmHg，或伴有糖尿病或三种公认的心血管危险因素）；其余 759 名患者处于中低风险。低出生体重（<2500g：比值比（OR）=1.67，P=0.02；2500-<3000g：OR=1.64，P<0.01；3000-<3500g，OR=1.40，P=0.01）、高血压家族史（OR=1.73，P<0.01）、教育程度低（OR=1.76，P<0.01）和酗酒（OR=3.05，P<0.01）显著预测晚年高危高血压。对于有高血压家族史的参与者（57.7%），出生体重与高血压的关联不再显著，但教育程度低（OR=2.33，P<0.01）和酗酒（OR=3.10，P=0.01）仍然很重要。对于没有高血压家族史的参与者（42.3%），低出生体重（<2500g：OR=2.26，P=0.02；2500-<3000g：OR=1.91，P=0.01；3000-<3500g，OR=1.78，P=0.01）和酗酒（OR=3.23，P<0.01）的影响仍然显著。
低出生体重、低教育程度、酗酒和高血压家族史与晚年高血压状态有关。低出生体重也与遗传背景有关；而与教育程度和酗酒的关联与高血压家族史无关。
