Presion Arterial En Niños

Birth Weight, Postnatal Weight Change, and Risk for High Blood Pressure Among Chinese Children
-------------------------------------------------
Abstract
BACKGROUND:
It is hypothesized that a physiological predisposition toward hypertension results from a combination of intrauterine growth restriction or overgrowth and excessive postnatal weight gain. Previous studies were conducted largelyin Western countries however the hypothesis may also be relevant in developing countries where metabolic disorders are increasing.
OBJECTIVE:
We investigated the association of birth weight and postnatal weight gain with hypertension among Chinese children.
METHODS:
A population based study was conducted among 15 600 children aged 3 to 6 years from Tianjin, China. Weight was expressedas z scores. Postnatal weight gain was defined as changes in z scores from birth to 3 to younger than 4 years, 4 to younger than 5 years, and 5 to 6 years. Hypertension was defined as greater than the 90th percentile of either systolic or diastolic blood pressure. Logistic regression-derived odds ratios and 95% confidence intervals were generated to estimate the association between birth weight and postnatalweight gain with hypertension risk in childhood.
RESULTS:
Birth weight was positively associated with childhood hypertension in boys and girls (odds ratios [95% confidence interval] comparing extreme quartiles [high versus low] were 5.67 [3.83–8.39] and 2.58 [3.83–8.39], respectively). Postnatal weight gain was positively associated with hypertension and the association did not significantlyvary by birth size for gestational age.
CONCLUSIONS:
Greater birth weight or postnatal weight gain was associated with increased childhood hypertension risk, suggesting that intrauterine growth and postnatal weight gain may have implications on health during childhood.
Hypertension is a major modifiable risk factor for cardiovascular disease, a leading cause of death in China.1,2 Given thecorrelation between childhood and adult hypertension,3 identifying risk factors of childhood hypertension may contribute to the early prevention of hypertension and cardiovascular disorders in adulthood. In addition, childhood hypertension itself recently was identified as a risk factor for premature death.4 Although obesity is a major risk factor for childhood hypertension,5 hypertension is not fullyexplained by obesity, and additional risk factors should be characterized.
Conventionally, it is hypothesized that a physiological predisposition toward hypertension results from a combination of intrauterine growth restriction and excessive postnatal weight gain.6 The hypothesis proposes that in a nutrient-poor uterine environment, the fetus must make adaptations that promote survival; however,these adaptations are deleterious after birth when nutrients are plentiful. An inverse association has been observed between birth weight and hypertension in childhood through adulthood and also has been observed for cardiovascular disease,7 metabolic syndrome,8 and type 2 diabetes.9Emerging evidence indicates that the association between birth weight and metabolic disorders may not be linear. AU-shaped association between birth weight and increased risks of developing hypertension and other metabolic disorders later in life was observed,10,11 which leads to the expansion of the developmental origins of health and disease to include the role of excessive fetal growth and early overnutrition. This may be particularly relevant in some developing countries, such as China, where the influx ofWestern lifestyles are escalating and, as a result, the occurrence of overnutrition, macrosomia, childhood obesity, hypertension, and other metabolic diseases are increasing rapidly.12 Previous studies on the association of birth weight and childhood hypertension, however, were conducted largely in Western countries, and studies among developing countries are sparse. In the present study, we...