Whincup P, Cook D, Papacosta O, Walker M
Birth weight and blood pressure: Cross-sectional and longitudinal relations in childhood

Brit Med J (Sep) 311:773-776 1995

Norms of arterial pressure increase with age during childhood and vary also with body mass. Several, but not all cross sectional studies have previously demonstrated an inverse relationship between birthweight and later blood pressure. The current investigation of blood pressure in 1511 9-11 year old children in the UK (including 549 studied previously at age 5-7) showed a significant negative correlation between both systolic and diastolic BP (when adjusted for age, sex, height, and body mass index) and birthweight (based on maternal recall). Systolic BP rose more rapidly between ages 5-7 and 9-11 in those subjects with lower birthweight, an effect which was stronger in girls than boys.

Investigators paid scrupulous attention to proper blood pressure measurement and quality of data were good. Study conclusions appear limited by relative lack of many low and very low birthweight children, by lack of other historical/family data, and by relative ethnic homogeneity of the study population. Whether these data are predictive of adolescent or adult BP is uncertain, especially given other published series; and whether they support the recent notion of birthweight as a surrogate for nephron mass in dictating longterm blood pressure control remains entirely speculative. (Umans)

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H: Diagnosis : Preadolescent and adolescent