Childhood Malnutrition Raises Hypertension Risk Later in Life
Ingrid A. Tennant, MBBS, of the University of the West Indies in Kingston, Jamaica, and colleagues studied cardiovascular structure and function in 116 adult survivors of severe acute malnutrition (SAM) and 45 community controls matched by age, sex, and body mass index.
After adjusting for age, sex, height, and weight, the researchers found that SAM survivors, compared with controls, had reductions (mean ± standard error) in left ventricular outflow tract diameter (0.67 ± 0.16; P<0.001), stroke volume (0.44 ± 0.17; P=0.009), cardiac output (0.5 ± 0.16; P=0.001), and pulse wave velocity (0.32 ± 0.15; P=0.03), but higher diastolic pressures (4.3mmHg; 95% confidence interval [CI], 1.2–7.3mmHg; P=0.007). In marasmus and kwashiorkor survivors, compared with controls, systemic vascular resistance was higher (30.2 ± 1.2 and 30.8 ± 1.1, respectively, vs. 25.3 ± 0.8; overall difference, 5.5; 95% CI, 2.8–8.4mmHgmin/L; P<0.0001).
"We conclude that adult SAM survivors had smaller outflow tracts and cardiac output when compared with controls, yet markedly elevated peripheral resistance," the authors write. "Malnutrition survivors are thus likely to develop excess hypertension in later life, especially when exposed to obesity."