FETAL INFLUENCES ON ADULT HYPERTENSION

Studies of population samples of adults and children consistently show a relation between lower birthweight and higher subsequent blood pres sure (BP). This relation is not present in the neonatal period or in a dolescence, which may reflect the unusual dynamics of growth at these times. We suggest that the inverse relation of BP with birthweight is a result of fetal adaptations to an adverse environment, particularly undernutrition. In making these adaptations, long-term physiology or m etabolism is changed in a way that leads to subsequent higher BP. Such changes may be in the structure of blood vessels, or the re-programmi ng of influential hormonal axes, such as the pituitary adrenal axis.