Abstract
BackgroundEarly-life developmental adaptations in response to severe malnutrition may play a crucial role in susceptibility to hypertension. This study aimed to explore the associations between exposure to the Chinese famine (1959–1961) at fetal, infant and preschool stages during fetal life or childhood and the risk of hypertension in adulthood.MethodsWe used the data of 1,966 adults born between 1956 and 1964 in selected families from the China Health and Retirement Longitudinal Study (CHARLS) national survey.ResultsPrevalence of hypertension among adults in non-exposed, fetal-exposed, infant-exposed, and preschool-exposed cohorts was 18.9, 20.7, 28.7, and 23.4 %, respectively. In severely affected famine areas, only infant-exposed cohort had a significant increased risk of hypertension compared with non-exposed cohort (OR 2.12; 95 % CI 1.19, 3.79; P = 0.011), and the significance remained after adjusted gender, smoking, and drinking (OR 2.11; 95 % CI 1.18, 3.77; P = 0.012). After stratification by BMI and economic status, the risk of hypertension was higher for subjects with BMI ≥ 24 kg/m2(OR 2.09; 95 % CI 1.09, 4.01; P = 0.026) or high economic status(OR 2.26; 95 % CI 1.19, 4.31; P = 0.013) than those with BMI < 24 kg/m2(OR 1.65; 95 % CI 0.71, 3.83; P = 0.246) or low economic status (OR 2.18; 95 % CI 1.14, 4.18; P = 0.019) in infant-exposed cohort of severely affected famine areas. However, there was no consistent association observed in less severely affected area or other exposed cohorts in severely affected areas.ConclusionsInfanthood exposed to famine might increase the risk of hypertension in adulthood, and a postnatal ‘rich’ nutrient environment further increased the risk.
Highlights
Early-life developmental adaptations in response to severe malnutrition may play a crucial role in susceptibility to hypertension
The Developmental Origins of Health and Disease (DOHaD) hypothesis postulates that adaptations in response to fetal malnutrition lead to metabolic and structural changes, which are beneficial for early survival, but may increase the risk of common diseases such as hypertension in adulthood [1,2,3,4,5]
Another study based on the 2002 China National Nutrition and Health Survey found that fetal, early-child and mid-child severely famine exposure were significant increased the risk of hypertension, but the age was not adjusted in statistical analyses [11]
Summary
Early-life developmental adaptations in response to severe malnutrition may play a crucial role in susceptibility to hypertension. This study aimed to explore the associations between exposure to the Chinese famine (1959–1961) at fetal, infant and preschool stages during fetal life or childhood and the risk of hypertension in adulthood. Another study based on the 2002 China National Nutrition and Health Survey found that fetal, early-child and mid-child severely famine exposure were significant increased the risk of hypertension, but the age was not adjusted in statistical analyses [11]. All the exposed groups were older than non-exposed group, and the effect of age on hypertension cannot be excluded Because of those limits in previous studies, further studies to explore the association between early life famine exposure and hypertension are in need
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