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Published on: January 7, 2018
Very preterm birth is a risk factor for increased systolic blood pressure at a young adult age
Mandy G Keijzer-Veen1, Arzu Dülger, Friedo W Dekker
1Department of Pediatric Nephrology, Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands. m.keijzer-veen@erasmusmc.nl
Insights
Individuals born very prematurely face an increased risk of developing high blood pressure in adulthood. This study found higher daytime systolic blood pressure in young adults born very preterm compared to full-term controls.
Area of Science:
- Pediatrics
- Cardiology
- Neonatology
Background:
- Intrauterine growth retardation (IUGR) in premature infants (<32 weeks gestation) is linked to adult hypertension risk.
- Renal function may be compromised in young adults born prematurely.
Purpose of the Study:
- To investigate the impact of very preterm birth on blood pressure in young adulthood.
- To assess differences in blood pressure and renin concentration between preterm and full-term individuals.
Main Methods:
- Measured 24-h ambulatory blood pressure and renin concentration in 50 very preterm individuals (small for gestational age [SGA] and appropriate for gestational age [AGA]) and 30 full-term controls.
- Participants were 20 years old at the time of measurement.
Main Results:
- Young adults born very preterm (both SGA and AGA) exhibited higher mean daytime systolic blood pressure compared to controls.
- Specifically, SGA preterm individuals had 3.6 mmHg higher systolic blood pressure, and AGA preterm individuals had 4.2 mmHg higher systolic blood pressure than controls.
- No significant differences were observed in daytime diastolic or nighttime blood pressure between the groups.
Conclusions:
- Very preterm birth is associated with elevated daytime systolic blood pressure in young adulthood.
- Individuals born very preterm may have an increased risk of developing hypertension later in life.
Abstract:
Children born very prematurely who show intrauterine growth retardation (IUGR) are suggested to be at risk of developing high blood pressure as adults. Renal function may already be impaired by young adult age. To study whether very preterm birth affects blood pressure in young adults, we measured 24-h ambulatory blood pressure (Spacelabs 90207 device) and renin concentration in 50 very premature individuals (<32 weeks of gestation), either small (SGA) or appropriate (AGA) for gestational age (21 SGA, 29 AGA), and 30 full-term controls who all were aged 20 years at time of measurement. The mean (standard deviation) daytime systolic blood pressure in SGA and AGA prematurely born individuals, respectively, was 122.7 (8.7) and 123.1 (8.5) mmHg. These values were, respectively, 3.6 mmHg [95% confidence interval (CI) -0.9 to 8.0] and 4.2 mmHg (95% CI 0.4-8.0) higher than in controls [119.6 (7.6)]. Daytime diastolic blood pressure and nighttime blood pressure did not differ between groups. We conclude that individuals born very preterm have higher daytime systolic blood pressure and higher risk of hypertension at a young adult age.
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Physiological Factors:
Measurement of Blood Pressure
Pre-Procedural Guidelines for Assessing Blood Pressure
Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
Blood Pressure
