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HomeCirculationVol. 115, No. 5Issue Highlights Free AccessIn BriefPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessIn BriefPDF/EPUBIssue Highlights Originally published6 Feb 2007https://doi.org/10.1161/circ.115.5.547Circulation. 2007;115:547ASSOCIATIONS OF GESTATIONAL AGE AND INTRAUTERINE GROWTH WITH SYSTOLIC BLOOD PRESSURE IN A FAMILY-BASED STUDY OF 386 485 MEN IN 331 089 FAMILIES, by Lawlor et al.Many previous studies have provided support for the fetal origins of disease. Investigators have hypothesized that fetal undernutrition contributes to poor growth and programs individuals for hypertension in later life. Skeptics have raised concerns, however, that studies supporting the developmental origins hypothesis may reflect residual confounding by socioeconomic factors. Lawlor and colleagues took advantage of Swedish birth and military service registries of 386 485 singleton-born men from 331 089 families to study the associations of birth weight and gestational age with subsequent systolic blood pressure at age 17 to 19 years. The investigators report that birth weight was inversely associated with systolic blood pressure; per 1-SD difference in birth weight, there was a −0.21 mm Hg difference in siblings, whereas nonsiblings had −0.12 mm Hg lower systolic blood pressure. They also observed that increasing gestational age was inversely associated with young adult systolic blood pressure. By taking advantage of a large unique sibling data set, the Lawlor et al study suggests that the link between gestational age, lower birth weight, and adult blood pressure does not merely reflect confounding by socioeconomic status. See p 562.EFFECTS OF NORMAL BLOOD PRESSURE, PREHYPERTENSION, AND HYPERTENSION ON CORONARY MICROVASCULAR FUNCTION, by Erdogan et al.Coronary flow reserve (CFR) has been shown to be impaired in patients with hypertension. Left ventricular hypertrophy contributes, but other mechanisms likely contribute as well. Prehypertension is also associated with an increased cardiovascular morbidity and mortality. Whether prehypertension is associated with impaired CFR is less well studied. The study by Erdogan et al in this issue of Circulation evaluated CFR using transthoracic Doppler echocardiography before and after intravenous dipyridamole infusion. CFR was significantly lower in hypertensive patients than in prehypertensive and normal patients, but prehypertension was also lower than in normal patients. Both hypertension and prehypertension were significant predictors of a lower CFR in a multivariable model. Other factors included systolic and diastolic blood pressure, high-sensitivity C-reactive protein levels, left atrial diameter mitral E deceleration time, and mitral A velocity. These findings are consistent with the concept that mildly elevated blood pressure is associated with abnormal coronary flow response, although the degree of impairment is less than in hypertension. See p 593.DETECTION OF CORONARY MICROEMBOLIZATION BY DOPPLER ULTRASOUND IN PATIENTS WITH STABLE ANGINA PECTORIS UNDERGOING ELECTIVE PERCUTANEOUS CORONARY INTERVENTIONS, by Bahrmann et al.During percutaneous coronary intervention, mechanical disruption of the atherosclerotic plaque by balloon inflation may result in embolization of particles to the microvasculature, resulting in increased postprocedural troponin and high-sensitivity C-reactive protein levels. Mechanistic studies have found that once coronary microvascular occlusion occurs, this leads to ventricular contractile dysfunction. Interestingly, this phenomenon was attributed to an inflammatory reaction and not a decrease in blood flow. Previous studies have shown that an intracoronary Doppler guide wire is able to detect, and quantify, in real time, microemboli that are released by percutaneous coronary intervention. In this issue of Circulation, Bahrmann et al extend these findings to demonstrate the relationship between percutaneous coronary intervention–induced coronary microembolization and postprocedural increases in myocardial necrosis and inflammation. See p 600.Visit http://circ.ahajournals.org:Clinician UpdateApical Ballooning Syndrome: An Important Differential Diagnosis of Acute Myocardial Infarction. See p e56.Images in Cardiovascular MedicineLeft Ventricular Aneurysm Associated With Mucopolysaccharidosis Type VI Syndrome (Maroteaux–Lamy Syndrome). See p e60.Tricyclic Cardiotoxicity Treated With Sodium Bicarbonate. See p e63.An Unusual Cause of Hand Cellulitis. See p e65. Download figureDownload PowerPointCorrespondenceSee p e67. Previous Back to top Next FiguresReferencesRelatedDetails February 6, 2007Vol 115, Issue 5 Advertisement Article InformationMetrics https://doi.org/10.1161/circ.115.5.547 Originally publishedFebruary 6, 2007 PDF download Advertisement