Birth weight and young adult body mass index for predicting the risk of developing adult heart failure in men

Abstract

Aims Hospitalizations for heart failure among young adults and middle-aged individuals have increased. The aims of the present study were to evaluate the association between birth weight and risk of adult heart failure and the importance of change from low birth weight to overweight/obesity at young adulthood. Methods and results We used the population-based body mass index (BMI) Epidemiology Study cohort Gothenburg (n = 35 659) with birth weight and young adult BMI (20 years) available from child healthcare records, school health records, and military conscription register for men born 1945–1961. The cohort includes all children who finished school, which was mandatory, in Gothenburg, Sweden. Information on heart failure diagnosis was retrieved from the National Patient Register and the Cause of Death Register (n = 415). In cox regression analyses, there was an inverse association between birth weight and risk of heart failure [hazard ratio (HR) 0.83 per standard deviation (SD), 95% confidence interval (CI) 0.76–0.90], and a direct association for young adult BMI (HR 1.48 per SD, 95% CI 1.36–1.61). Of note, individuals with birth weight in the lowest tertile, who were overweight/obese in young adulthood had a five-fold risk of heart failure (HR 4.95, 95% CI 3.36–7.31) compared with individuals in the middle birth weight tertile who were normal weight at 20 years. Conclusions Birth weight was inversely associated with the risk of hospitalization due to heart failure. The combination of low birth weight and overweight/obesity in young adulthood results in excess risk of heart failure beyond that of low birth weight or young adult overweight/obesity separately. These findings indicate the need of a life course perspective in heart failure prevention and risk assessment.

The Swedish military conscription register: opportunities for its use in medical research

“…Members of our research group and others have previously studied the prevalence of obesity [30][31][32], and its association with mortality [33,34] and cardiovascular health [8,[35][36][37][38][39]. Still other researchers have demonstrated that heart rate and blood pressure at conscription may be linked to the risk of psychiatric disorders later in life [23,40].…”

Cardiovascular prevention in childhood: a consensus document of the Italian Society of Cardiology Working Group on Congenital Heart Disease and Cardiovascular Prevention in Paediatric Age

“…17,18 Small for gestational age infants display high and early onset rates of hypertension (immature nephrogenesis results in the development of kidneys with a reduced number of filtrating units known as nephrons), stroke and diabetes in adulthood. [19][20][21][22] Also the prevalence of coronary artery disease is higher in these people than in their peers born with normal weight in the medium and long term. 23 An inverse and independent of body mass index (BMI) relationship between low birth weight and stroke among adult men has recently been described.…”

“…Small for gestational age infants display high and early onset rates of hypertension (immature nephrogenesis results in the development of kidneys with a reduced number of filtrating units known as nephrons), stroke and diabetes in adulthood 19–22 …”

Preterm Birth, Small for Gestational Age, and Large for Gestational Age and the Risk of Atrial Fibrillation Up to Middle Age

“…Restricted and excessive fetal growth, as reflected in small and large for gestational age (SGA and LGA, respectively), have been linked to increased risks of cardiovascular diseases (CVD), including hypertension, ischemic heart disease (IHD), stroke, heart failure, and other cardiometabolic disorders in childhood and adulthood . Short gestational age, as reflected in preterm birth, was also found to be associated with increased risks of IHD, stroke, and heart failure, irrespective of fetal growth .…”