Fetal exposure, heredity and risk indicators for cardiovascular disease ina Swedish welfare cohort

Background The overall aim was to test whether low birthweight (LBW) in new borns is associated with the risk indicators for cardiovascular disease in early middle age, even in a welfare society. Further, a possible interactio n of LBW and heredity for myocardial infarction or stroke was investigated. Methods Overall, subjects were identified as newborns in a local birth regi ster, and as adult participants, in the Vasterbotten Intervention Program ( n=7876). Outcome measures such as systolic (SBP) and diastolic blood pressu res (DBP), body mass index (BMI), cholesterol, triglycerides and anthropome trics were investigated (at age 29-41 years) in relation to LBW. Results Low birthweight was associated with increased SBP and DBR Triglycer ides were elevated among women with LBW and total cholesterol was elevated in men with LBW. Heredity for myocardial infarction or stroke interacted wi th LBW, and indicated a synergistic effect on the level of SBP. The BMI did not differ between LBW and normal birthweight subjects. Conclusions Our interpretation is that the 'fetal origins' hypothesis' is v alid for middle-age subjects who grow up in a welfare society. The populati on attributable proportions that result from different exposures to LBW wer e relatively small overall, from a public health perspective, heredity was more important than LBW for elevated SBP.