Birth Weight, Postnatal Growth, Blood Pressure and Subclinical Cardiovascular Dis

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DESCRIPTION (provided by applicant): Although the relationship between low birth weight and elevated blood pressure (BP) levels at various stages in later life has been well established, the association of birth weight with BP variations from childhood to adulthood has not been fully examined. In addition, the complex relationships among prenatal and postnatal growth, BP and subclinical changes of cardiovascular (C-V) structure and function need to be elucidated. The Specific Aims of the proposed research are 1) to demonstrate the inter-relationships among birth weight, longitudinal obesity measures and BP (levels and variability) from childhood to adulthood in black and white individuals, and 2) to determine the effect of birth weight in conjunction with BP (variability and levels) and postnatal growth on adulthood subclinical changes of C-V structure and function (arterial wall thickness, vascular stiffness and left ventricular structure and function). These specific aims will be examined using available longitudinal database from the Bogalusa Heart Study, a long-term biracial (65% white, 35% black) community-based study of the Natural History of C-V Disease beginning in childhood. The proposed study Cohort I for cross-sectional analyses consists of 6,458 individuals who have data on birth weight, growth parameters and BP in preadolescence, adolescence and adulthood; Cohort II for longitudinal analyses consists of 1,695 individuals who have data on birth weight and serial measurements of BP obtained at least 3 times each in childhood and at least 3 times in adulthood; Cohort III consists of 1,194 individuals who have data on birth weight, serial measurements of BP since childhood and subclinical changes of C-V system in adulthood. Long- term BP levels will be measured as the area under the curve derived from serial BP measurements from childhood to adulthood. Four BP variability measures (age-related trend, deviations around age-predicted values, deviations from mean and yearly rate of variability) will be calculated using longitudinal BP measurements. Path analysis (linear structural equation modeling) will be performed cross-sectionally by growth periods as well as using long-term BP level and variability measures. Interaction regression models along with principal components analysis will be applied to examine the joint effect of birth weight, obesity measures and BP on subclinical changes of C-V system. Findings from this research will provide further insights into the "fetal origins" of the development of hypertension. Deepening our understanding of the relationships among prenatal and postnatal growth, hemodynamics and subclinical C-V disease later in life has important implications for improving prenatal care and developing strategies beginning early in life to prevent adult C-V disease from hypertension. PUBLIC HEALTH RELEVANCE: Low birth weight is an indicator of baby growth restriction before birth and associated with adult heart disease, diabetes and hypertension. The findings from this research have important implications for improving prenatal care and developing strategies beginning early to prevent adult heart disease.