IS BLOOD-PRESSURE IN LATER LIFE AFFECTED BY EVENTS IN INFANCY

This article reviews experimental and clinical evidence of whether pri mary hypertension (HTN) later in life is influenced by events early in life. The experimental evidence is drawn from studies in inbred strai ns of HTN-prone rats the clinical evidence is drawn from studies in ch ildren and adults of the influence of genetics, nutrition, and stress on adult blood pressure (BP). Adult BP in HTN-prone rats is significan tly influenced in the preweaning period by salt intake and genetic fac tors regulating extracellular fluid volume, and by maternal-infant int eractions. BPs of children track with BPs of their parents. Children o f parents with primary HTN are insulin resistant and have lower averag e cation flux values across cell membranes as do their parents; childr en and their parents with secondary HTN do not. Children with low birt h weight have a higher prevalence of HTN as adults than better-nourish ed peers. Salt intake in children affects BP response to stress. Avera ge salt consumption among different cultures correlates with the preva lence of HTN in those cultures. Varying salt intake of infants and chi ldren has little influence on BP later in childhood. The evidence sugg ests simple measures that might lower the risk for HTN in HTN-prone ch ildren in general. However, at present we lack reliable means for iden tifying children at risk for HTN specific means to lower that risk.