Blood pressure, arterial compliance, and left ventricular mass: no relation to small size at birth in south Indian adults

Objective-To determine whether reduced fetal growth leads to raised blood p ressure, reduced arterial compliance, and increased left ventricular mass i n an Indian population. Design-A retrospective cohort study of men and women (age range 40-61 years ) whose weight, length, and head circumference at birth were recorded. Setting-The Holdsworth Memorial Hospital, Mysore, South India. Subjects-435 men and women born in the hospital between 1934 and 1953. Main outcome measures-Systolic and diastolic blood pressures; compliance in four arterial segments derived from pulse wave velocity, measured by a non -invasive optical method; and left ventricular mass measured using M mode e chocardiography. Results-Small size at birth was not associated with increased adult blood p ressure or left ventricular mass, or with reduced arterial compliance. Syst olic blood pressure and left ventricular mass were higher in subjects who w ere greater in length at birth, rising by 1.64 mm Hg (95% confidence interv al (CI) -0.08 to +3.37 mm Hg) and 1.63 g/m(2) (95% CI 0.13 to 3.13 g/m(2)), respectively, per one inch (2.5 cm) increase in birth length, independentl y of adult size. Arterial compliance was reduced in people whose mothers we re lighter and had smaller pelvic (external conjugate) diameters. Conclusions-The higher prevalence of coronary heart disease in Indian men a nd women of lower birth weight, shown in an earlier study of the same cohor t, cannot be explained by changes in blood pressure, arterial compliance, a nd left ventricular mass. The association of raised blood pressure and left ventricular mass with longer birth length suggests that the way in which t he intrauterine environment influences corollary heart disease differs betw een Indian and Western populations.