Carroll, D., Davey Smith, G., Phillips, A.C., Ring, C., & West, P. (2006). Birth-weight, adult blood pressure, and blood pressure reactions to acute psychological stress. Journal of Epidemiology and Community Health, 60, 144-145.

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Carroll, D., Davey Smith, G., Phillips, A.C., Ring, C., & West, P. (2006). Birth-weight, adult blood pressure, and blood pressure reactions to acute psychological stress. Journal of Epidemiology and Community Health, 60, 144-145.
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  Post-print, not final published version. Cite this article as: Carroll, D., Davey Smith, G., Phillips, A.C., Ring, C., & West, P. (2006). Birth-weight, adult blood pressure, and  blood pressure reactions to acute psychological stress.  Journal of Epidemiology and Community Health, 60, 144-145. http://dx.doi.org/10.1136/jech.2005.039305 IF 3.19 Birth-weight, adult blood pressure, and blood pressure reactions to acute psychological stress.  Douglas Carroll, PhD 1 , George Davey Smith, DSc 2 , Anna C. Phillips, MSc 1 ,Christopher Ring, PhD 1 , Patrick West, PhD 3   1 School of Sport and Exercise Sciences, University of Birmingham, Birmingham, England 2 Department of Social Medicine, University of Bristol, Bristol, England 3 MRC Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland Running head: Birth-weight and blood pressure Address correspondence to: Douglas Carroll, PhD, School of Sport and Exercise Sciences, University of Birmingham, Birmingham B15 2TT, England. Tel: 00 44 121 414 7240; Fax: 00 44 121 414 4121; e-mail carrolld@bham.ac.uk The Corresponding Author has the right to grant on behalf of all authors and does grant on behalf of all authors, an exclusive licence (or non exclusive for government employees) on a worldwide basis to the BMJ Publishing Group Ltd and its Licensees to  permit this article (if accepted) to be published in Journal of Epidemiology and Community Health editions and any other BMJPGL products to exploit all subsidiary rights, as set out in our licence  Post-print, not final published version. Cite this article as: Carroll, D., Davey Smith, G., Phillips, A.C., Ring, C., & West, P. (2006). Birth-weight, adult blood pressure, and  blood pressure reactions to acute psychological stress.  Journal of Epidemiology and Community Health, 60, 144-145. http://dx.doi.org/10.1136/jech.2005.039305 IF 3.19 (http://jech.bmjjournals.com/misc/ifora/licenceform.shtml).  Post-print, not final published version. Cite this article as: Carroll, D., Davey Smith, G., Phillips, A.C., Ring, C., & West, P. (2006). Birth-weight, adult blood pressure, and  blood pressure reactions to acute psychological stress.  Journal of Epidemiology and Community Health, 60, 144-145. http://dx.doi.org/10.1136/jech.2005.039305 IF 3.19 The foetal srcins of disease hypothesis contends that an unfavourable intra-uterine environment, as evidenced by low birth-weight, increases vulnerability to chronic illness in adulthood [1]. There is now reasonably consistent evidence of a negative association  between birth-weight and adult blood pressure [2]. However, the mechanisms underlying this relationship remain unclear. It has been suggested that individual differences in susceptibility to stress may play a role [3]. One way of assessing this susceptibility is by measuring blood pressure reactions to an acute psychological stress task. There is evidence that large magnitude blood pressure reactions to such exposures predict elevated resting blood pressure at subsequent follow up [4]. The present analyses revisited the issue of birth-weight and adult blood pressure and examined whether any association was mediated by individual differences in blood pressure reactions to acute stress. Participants, methods, and results Data were collected as part of the West of Scotland Twenty-07 Study [5]. Participants were 560 adults (260 men, 300 women), not taking antihypertensive medication, aged 23 to 25 years old (mean age = 23.7,  SD  = 0.6 years), with a mean measured weight of 70.5 ( SD  = 13.5) kilograms. Birth-weight information, collected eight years earlier from the  participants ’ mothers, was available for 533  of the participants; average birth-weight was 3359 ( SD  = 585) grams. Testing sessions were conducted by trained nurses in a quiet room in the  participants’ homes. Systolic (SBP) and diastolic (DBP) blood pressure were determined  by a validated semi-automatic sphygmomanometer at rest and twice during a 3-minute stress task, the paced auditory serial addition test, described elsewhere [4]. There is evidence that individual differences in reaction to tasks of this sort are stable over time and are associated with reactivity in ‘real life’ [6].  The task readings were averaged, and the resting baseline value subtracted to yield reactivity measures for SBP, and DBP. Mean (SD) SBP and DBP at rest was 120 (15.0) and 73 (10.0), and mean (SD) reactivity was 10 (11.1) and 7 (9.0) mmHg, indicating that the task perturbed blood  pressure (p < .001 in both cases). Given that men were heavier than women at birth (p = .01) and that the inverse association between birth-weight and adult blood pressure in  Post-print, not final published version. Cite this article as: Carroll, D., Davey Smith, G., Phillips, A.C., Ring, C., & West, P. (2006). Birth-weight, adult blood pressure, and  blood pressure reactions to acute psychological stress.  Journal of Epidemiology and Community Health, 60, 144-145. http://dx.doi.org/10.1136/jech.2005.039305 IF 3.19 many studies is strengthened, or only becomes apparent, with adjustment for adult weight, hierarchical regression analysis adjusted for both sex and adult weight. In these analyses there was a significant association between birth-weight and adult SBP, but not DBP (see Table 1). In similar analyses, there was no association between SBP and DBP reactivity, (β = .04, p = .40 and β = .02, p = .72) . In addition, the association between  birth-weight and adult SBP remained significant following adjustment for reactivity (p = .04). Comment These analyses confirm the negative association between birth-weight and adult blood  pressure. However, the association was significant only for SBP, was manifest only after adjustment for adult weight, and withstood additional adjustment for SBP reactivity. Thus, it would appear that it is differences in growth trajectory that predict variations in  blood pressure. Individual differences in stress reactivity in the present study would not seem to play a mediating role, although the possibility of such mediation cannot be completely discounted on the basis of these data. In addition, the negative association  between birth-weight and adult SBP was much weaker than the positive association  between contemporary weight and SBP [2]. References   1.   Barker, DJP.  Fetal Origins of Adult Disease. London: British Medical Journal, 1992. 2.   Lawlor, DA, Davey Smith, G. Early life determinants of adult blood pressure. Current Opinion in Nephrology and Hypertension  2005; 14 : 259-64. 3.    Nilsson, PM, Nyberg, P, Ostergren, P-O. Increased susceptibility to stress at a  psychological assessment of stress tolerance is associated with impaired fetal growth.  Int J Epidemiol   2001; 30 : 75-80. 4.   Carroll, D, Ring, C, Hunt, K, et al. Blood pressure reactions to stress and the  prediction of future blood pressure: Effects of sex, age, and socioeconomic  position.  Psychosom Med 2003; 65 : 1058-64.  Post-print, not final published version. Cite this article as: Carroll, D., Davey Smith, G., Phillips, A.C., Ring, C., & West, P. (2006). Birth-weight, adult blood pressure, and  blood pressure reactions to acute psychological stress.  Journal of Epidemiology and Community Health, 60, 144-145. http://dx.doi.org/10.1136/jech.2005.039305 IF 3.19 5.   Ford, G, Ecob, R, Hunt, K, et al. Patterns of inequality in health through the lifespan: Class gradients at 15, 35, and 55 years in the west of Scotland. Soc Sci  Med 1994; 39 : 1037-50. 6.   Parati, G, Pomidossi, G, Casadei, R, et al. Limitations of lab stress testing in the assessment of subjec ts’ cardiovascular reactions to stress.  J Hypertens  1986; 4 : S51-S53.
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