Joint association between birth weight at term and later life adherence to a healthy lifestyle with risk of hypertension: a prospective cohort study

BMC Medicine

Lu Qi²  Frank B. Hu²  John P. Forman⁴  Walter C. Willett²  Janet W. Rich-Edwards⁵  Gary C. Curhan⁴  Tyler J. VanderWeele³  Sylvia H. Ley¹  Yanping Li¹ 

[1] Department of Nutrition, Harvard School of Public Health, Boston, MA, USA;Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, 665 Huntington Ave, Boston 02115, MA, USA;Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA;Renal Division, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA;The Connors Center for Women’s Health and Gender Biology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

关键词: Women;    Nutrition;    Lifestyle;    Hypertension;   

Others  :  1221505
DOI  :  10.1186/s12916-015-0409-1

 received in 2015-02-04, accepted in 2015-06-25,  发布年份 2015

【 摘 要 】

Background

Low birth weight and unhealthy lifestyles in adulthood have been independently associated with an elevated risk of hypertension. However, no study has examined the joint effects of these factors on incidence of hypertension.

Methods

We followed 52,114 women from the Nurses’ Health Study II without hypercholesterolemia, diabetes, cardiovascular disease, cancer, prehypertension, and hypertension at baseline (1991–2011). Women born preterm, of a multiple pregnancy, or who were missing birth weight data were excluded. Unhealthy adulthood lifestyle was defined by compiling status scores of body mass index, physical activity, alcohol consumption, the Dietary Approaches to Stop Hypertension diet, and the use of non-narcotic analgesics.

Results

We documented 12,588 incident cases of hypertension during 20 years of follow-up. The risk of hypertension associated with a combination of low birth weight at term and unhealthy lifestyle factors (RR, 1.95; 95 % CI, 1.83–2.07) was more than the addition of the risk associated with each individual factor, indicating a significant interaction on an additive scale (P_interaction<0.001). The proportions of the association attributable to lower term birth weight alone, unhealthy lifestyle alone, and their joint effect were 23.9 % (95 % CI, 16.6–31.2), 63.7 % (95 % CI, 60.4–66.9), and 12.5 % (95 % CI, 9.87–15.0), respectively. The population-attributable-risk for the combined adulthood unhealthy lifestyle and low birth weight at term was 66.3 % (95 % CI, 56.9–74.0).

Conclusion

The majority of cases of hypertension could be prevented by the adoption of a healthier lifestyle, though some cases may depend on simultaneous improvement of both prenatal and postnatal factors.

【 授权许可】

   
2015 Li et al.

【 图 表 】

Fig. 1.

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