Birth weight as a predictor of future hypertension

According to the concept of “fetal programming,” intrauterine conditions that impair fetal growth can program the fetus to express hypertension, as well as other chronic diseases, in later life. A model for the development of hypertension that includes the effect of the intrauterine environment on fetal growth as a mechanistic pathway contributes a new dimension in causality and is of great interest. Experimental studies that apply maneuvers to impose fetal undernutrition in animal models have developed data that support this concept. The evidence developed from epidemiologic investigations on humans is less conclusive. Overall, there tends to be a small but consistent relationship of lower birth weight with higher blood pressure (BP). For each kilogram increase in birth weight, the systolic BP is 1 to 2 mm Hg lower.