Perinatal origins of adult disease

Abstract

Hypertension is common though its aetiology is still not clear. Approximately ~20 to 25% of the population above the age of 40 years have elevated blood pressure, detected or undetected^1,2. It is estimated that a 2% reduction of mean blood pressure (about 3 mm Hg in diastolic pressure) has the potential to prevent 1.2 million deaths from stroke (which form about 15% of all deaths from stroke) and 0.6 million from CHD (6% of all deaths from CHD) every year by 2020 in the Asia Pacific region alone³. Hitherto, efforts have been concentrated on identifying the aetiological factor(s). But more efforts should be diverted to identify the best ways of enabling people and populations to lower their risk of hypertension and consequent cardiovascular disease. In this context, the relationship between birth weight and development of hypertension in later life looks interesting. It is widely recognised that high blood pressure is multi-factorial in origin and some of these factors include consumption of a western-style diet high in sodium and low in calcium and potassium. Nevertheless, the idea that some perinatal factors can influence blood pressure in later life is not only interesting but, may also throw new light on the aetiopathogenesis of hypertension.