Antenatal Programming of Blood Pressure

South, Andrew M.

doi:10.1007/978-3-031-06231-5_57

Cited by 2 publications

(1 citation statement)

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“…As an overall imbalanced renin-angiotensin-aldosterone system tone (i.e., lower angiotensin-(1-7) relative to higher or normal angiotensin II) may serve to exacerbate sympathetic effects on sodium excretion and BP control [35]. However, a knowledge gap remains in how this stress response relates to Na þ /K þ ATPase upregulation as a result of prematurity and low birth weight [36,37].…”

Section: Discussionmentioning

confidence: 99%

The role of preterm birth in stress-induced sodium excretion in young adults

Tully,

Chappell,

Evans

et al. 2024

Journal of Hypertension

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Background: Early-life programming due to prematurity and very low birth weight (VLBW, <1500 g) is believed to contribute to development of hypertension, but the mechanisms remain unclear. Experimental data suggest that altered pressure natriuresis (increased renal perfusion pressure promoting sodium excretion) may be a contributing mechanism. We hypothesize that young adults born preterm will have a blunted pressure natriuresis response to mental stress compared with those born term. Methods: In this prospective cohort study of 190 individuals aged 18–23 years, 156 born preterm with VLBW and 34 controls born term with birth weight at least 2500 g, we measured urine sodium/creatinine before and after a mental stress test and continuous blood pressure before and during the stress test. Participants were stratified into groups by the trajectory at which mean arterial pressure (MAP) increased following the test. The group with the lowest MAP trajectory was the reference group. We used generalized linear models to assess poststress urine sodium/creatinine relative to the change in MAP trajectory and assessed the difference between groups by preterm birth status. Results: Participants’ mean age was 19.8 years and 57% were women. Change in urine sodium/creatinine per unit increase in MAP when comparing middle trajectory group against the reference group was greater in those born preterm [β 5.4%, 95% confidence interval (95% CI) -11.4 to 5.3] than those born term (β 38.5%, 95% CI -0.04 to 92.0), interaction term P = 0.002. Conclusion: We observed that, as blood pressure increased following mental stress, young adults born preterm exhibited decreased sodium excretion relative to term-born individuals.

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Section: Discussionmentioning

confidence: 99%