Fetal and childhood growth and hypertension in adult life

The association between low birth weight and raised blood pressure has been extensively replicated. Little is known about the way childhood growth mod ifies the effects of low birth weight. We report on the fetal and childhood growth of 1958 men and women who received treatment for hypertension and b elong to a cohort of 7086 people born in Helsinki, Finland, during 1924-193 3. As expected, the men and women who developed hypertension had low birth weight (P = 0.002), They were also shorter in body length at birth (P = 0,0 2). After birth they experienced accelerated growth, so that by 7 years the ir heights and weights were approximately average. In a simultaneous regres sion, both birth length and tall height had statistically significant altho ugh opposing effects on hypertension (P = 0.003 for birth length and 0.009 for height at 7 years). Accelerated postnatal growth was associated with be tter childhood living conditions. Children who later developed both hyperte nsion and type 2 diabetes, rather than hypertension alone, had small placen tal size as well as small body size at birth, and their accelerated postnat al growth continued beyond 7 years. We suggest that hypertension may origin ate through retarded growth in utero followed by accelerated postnatal grow th as a result of good living conditions. Retarded fetal growth leads to pe rmanently reduced cell numbers in the kidney and other tissues, and subsequ ent accelerated growth may lead to excessive metabolic demand on this limit ed cell mass.