Uiterwaal C S, Anthony S, Launer L J, Witteman J C, Trouwborst A M, Hofman A, Grobbee D E
Department of Epidemiology and Biostatistics, Erasmus University Medical School, Rotterdam, The Netherlands.
Hypertension. 1997 Aug;30(2 Pt 1):267-71. doi: 10.1161/01.hyp.30.2.267.
Associations between birth weight and blood pressure have been found in children and adults. In this longitudinal study, the objective was to assess the relation between birth weight and blood pressure level and the change in blood pressure from childhood and young adolescence into adulthood. A cohort of 483 children from a middle-class community in the town of Zoetermeer in the Netherlands had annual measurements of blood pressure during an average follow-up period of 14 years. For 330 of these participants, initially aged 5 through 21 years, birth weight data were collected, which were related to blood pressure level and blood pressure change. An inverse association between birth weight and systolic blood pressure was found, with adjustment for current body height and weight, sex, and use of alcohol, cigarettes, and oral contraceptives. This inverse association was found for the total follow-up in 5- to 37- year-olds (regression coefficient: -2.4 mm Hg/kg; 95% confidence interval: -3.9 to -1.0, as well as in most individual age groups: 5 through 9 years (-0.6 mm Hg/kg, -3.2 to 2.0); 10 through 14 years (-2.5 mm Hg/kg, -4.7 to -0.4); 15 through 19 years (-3.1 mm Hg/kg, -4.9 to -1.2); 20 through 24 years (-2.7 mm Hg/kg, -4.6 to -0.9); 25 through 29 years (-2.0 mm Hg/kg, -3.9 to -0.01); and 30 through 37 years (-1.9 mm Hg/kg, -4.6 to 0.7). For diastolic blood pressure, there appeared to be an inverse association with birth weight in the age group of 30 through 37 years, both unadjusted (-2.0 mm Hg/kg, -4.6 to 0.5) and adjusted for risk factors other than sex (-2.3 mm Hg/kg, -4.7 to 0.1), although these findings were of borderline statistical significance. The results were independent of gestational age and were similar in the group of subjects with low birth weight but normal gestational age (-2.7 mm Hg/kg, -4.3 to -1.0). In relation to systolic blood pressure, birth weight showed a significant interaction with body mass index (regression coefficient, 0.02; SE=0.01; P=.05). There was no relation between birth weight and change in systolic or diastolic blood pressure with age. Our longitudinal study shows that birth weight is consistently inversely associated with systolic blood pressure level from childhood to young adulthood and with diastolic blood pressure in young adulthood. Birth weight is not related to change of blood pressure with increasing age. Low birth weight in combination with high current body mass index seems to be of particular importance in the development of high blood pressure.
出生体重与血压之间的关联在儿童和成人中均已被发现。在这项纵向研究中，目标是评估出生体重与血压水平之间的关系以及从儿童期和青少年早期到成年期血压的变化。荷兰祖特梅尔镇一个中产阶级社区的483名儿童队列在平均14年的随访期内每年测量血压。对于其中330名最初年龄在5至21岁的参与者，收集了出生体重数据，并将其与血压水平和血压变化相关联。在对当前身高、体重、性别以及酒精、香烟和口服避孕药的使用情况进行调整后，发现出生体重与收缩压呈负相关。在5至37岁的整个随访期内发现了这种负相关（回归系数：-2.4 mmHg/kg；95%置信区间：-3.9至-1.0），在大多数个体年龄组中也是如此：5至9岁（-0.6 mmHg/kg，-3.2至2.0）；10至14岁（-2.5 mmHg/kg，-4.7至-0.4）；15至19岁（-3.1 mmHg/kg，-4.9至-1.2）；20至24岁（-2.7 mmHg/kg，-4.6至-0.9）；25至29岁（-2.0 mmHg/kg，-3.9至-0.01）；30至37岁（-1.9 mmHg/kg，-4.6至0.7）。对于舒张压，在30至37岁年龄组中，无论未调整（-2.0 mmHg/kg，-4.6至0.5）还是对除性别外的危险因素进行调整后（-2.3 mmHg/kg，-4.7至0.1），似乎都与出生体重呈负相关，尽管这些发现的统计学意义接近临界值。结果独立于胎龄，在出生体重低但胎龄正常的受试者组中也相似（-2.7 mmHg/kg，-4.3至-1.0）。关于收缩压，出生体重与体重指数显示出显著的相互作用（回归系数，0.02；标准误=0.01；P = 0.05）。出生体重与收缩压或舒张压随年龄的变化无关。我们的纵向研究表明，从儿童期到青年期，出生体重始终与收缩压水平呈负相关，在青年期与舒张压呈负相关。出生体重与血压随年龄增长的变化无关。低出生体重与当前高体重指数相结合似乎在高血压的发展中尤为重要。
