Evidence for Genetic Factors Explaining the Birth Weight–Blood Pressure Relation: Analysis in Twins

Epidemiological studies have consistently shown an inverse association between birth weight and systolic blood pressure in later life after adjustment for current size. To examine whether this association is explained by intrauterine or genetic factors, we investigated birth weight and blood pressure data in 53 dizygotic and 61 monozygotic adolescent twin pairs. Birth weight was obtained from the mothers. Blood pressure measurements were performed 6 times at rest and during mental stress. The dizygotic but not the monozygotic twins with the lowest birth weight from each pair had a systolic blood pressure measured at rest and during the reaction time experiment that was higher compared with their cotwins with the highest birth weight (dizygotic twins: blood pressure at rest, 119.4±9.7 mm Hg versus 117.3±8.5 mm Hg, P =0.07, and during a reaction time task, 126.2±10.8 versus 123.6±9.5, P =0.09; monozygotic twins: blood pressure at rest, 117.4±6.4 versus 118.4±9.0, P =0.4, and during a reaction time task, 122.9±8.4 versus 124.2±10.8, P =0.2). The differences in blood pressure between the cotwins with the lowest and the cotwins with the highest birth weight were different in dizygotic compared with monozygotic twin pairs (for blood pressure at rest, P =0.05; for blood pressure during reaction time, P =0.03). After adjustment for differences in current weight, intrapair differences in birth weight were negatively and significantly associated with differences in systolic blood pressure at rest and during the reaction time task in dizygotic twins (regression coefficient, −5.7 mm Hg/kg [95% confidence interval, −10.4 to −1.0] and −6.3 [−12.7 to 0], respectively) but not in monozygotic twins (−0.1 [−5.4 to 5.2] and +3.5 [−1.8 to 8.8], respectively). Interaction analysis indicated that the associations were different between dizygotic twins and monozygotic twins (P =0.1 and P <0.05, respectively). These data suggest that genetic factors may play an important role in the association between birth weight and blood pressure.

[1]  N. Fisk,et al.  Fetal origins of reduced arterial distensibility in the donor twin in twin-twin transfusion syndrome , 2000, The Lancet.

[2]  T. Spector,et al.  Association between birth weight and adult blood pressure in twins: historical cohort study , 1999, BMJ.

[3]  T. Dwyer,et al.  Within pair association between birth weight and blood pressure at age 8 in twins from a cohort study , 1999, BMJ.

[4]  T. Cole,et al.  Fetal origins of adult disease—the hypothesis revisited , 1999, BMJ.

[5]  P. Ryan,et al.  The relationship between birth weight and blood pressure amplifies from childhood to adulthood. , 1999, Journal of Hypertension.

[6]  A. Sherwood,et al.  High stress responsivity predicts later blood pressure only in combination with positive family history and high life stress. , 1999, Hypertension.

[7]  A. Hattersley,et al.  The fetal insulin hypothesis: an alternative explanation of the association of low bir thweight with diabetes and vascular disease , 1999, The Lancet.

[8]  C. Osmond,et al.  Blood pressure in adults after prenatal exposure to famine. , 1999, Journal of hypertension.

[9]  D J Barker,et al.  In utero programming of chronic disease. , 1998, Clinical science.

[10]  H. Snieder,et al.  Heritability of blood pressure increases during mental stress , 1998, Twin Research.

[11]  J S Yudkin,et al.  Does malnutrition in utero determine diabetes and coronary heart disease in adulthood? Results from the Leningrad siege study, a cross sectional study , 1997, BMJ.

[12]  D. Stevenson,et al.  Size at birth, maternal nutritional status in pregnancy, and blood pressure at age 17: population based analysis , 1997, BMJ.

[13]  J. Witteman,et al.  Birth weight, growth, and blood pressure: an annual follow-up study of children aged 5 through 21 years. , 1997, Hypertension.

[14]  D. Cook,et al.  Size at birth and blood pressure: cross sectional study in 8-11 year old children , 1997, BMJ.

[15]  E. Rimm,et al.  Birth weight and adult hypertension, diabetes mellitus, and obesity in US men. , 1996, Circulation.

[16]  J. Manson,et al.  Birth weight and adult hypertension and obesity in women. , 1996, Circulation.

[17]  C. Law,et al.  Is blood pressure inversely related to birth weight? The strength of evidence from a systematic review of the literature , 1996, Journal of hypertension.

[18]  G. Siest,et al.  Weights at birth and in early infancy, systolic pressure, and left ventricular structure in subjects aged 8 to 24 years. , 1996, Hypertension.

[19]  P. McKeigue,et al.  Failure to realise growth potential in utero and adult obesity in relation to blood pressure in 50 year old Swedish men , 1996, BMJ.

[20]  R. Hanson,et al.  Birth weight and non-insulin dependent diabetes: thrifty genotype, thrifty phenotype, or surviving small baby genotype? , 1994, BMJ.

[21]  A. Ades,et al.  Birth weight and body mass index in childhood, adolescence, and adulthood as predictors of blood pressure at age 36. , 1993, Journal of epidemiology and community health.

[22]  D. Boomsma,et al.  A Parent-Twin Study of Plasma Levels of Histidine-Rich Glycoprotein (HRG) , 1993, Thrombosis and Haemostasis.

[23]  K. Matthews,et al.  Cardiovascular reactivity to stress predicts future blood pressure status. , 1993, Hypertension.

[24]  D. Phillips,et al.  Twin studies in medical research: can they tell us whether diseases are genetically determined? , 1993, The Lancet.

[25]  D. Boomsma,et al.  Lipoprotein(a): relation to other risk factors and genetic heritability. Results from a Dutch parent-twin study. , 1993, Atherosclerosis.

[26]  N. Martin,et al.  Alpha-1-antitrypsin and blood pressure , 1991, The Lancet.

[27]  W. Paterson,et al.  Epidemiology of scabies: the new epidemic , 1991, The Lancet.

[28]  Simon J. M. Welham,et al.  Intrauterine programming of cardiovascular disease by maternal nutritional status. , 1998, Nutrition.