Lucilla Poston Pages 914 - 922 ( 9 )
Fetal growth restriction leading to low birthweight is associated with increased risk of ischaemic heart disease and hypertension in later life. Increasingly, it is recognised that cardiovascular risk may also be initiated in early life when the fetus and neonate are exposed to maternal nutritional excess. This review summarises the studies in man and animals that have investigated the potential role of vascular disorders in the aetiology of atherosclerosis and hypertension arising from early life nutritional deprivation or excess. Malfunction of the arterial endothelial cell layer in the offspring has been frequently described in association with both maternal under and overnutritional states and may play a permissive role in the origin of these disorders. Also prevalent is evidence for increased stiffness of the large arteries which may contribute to systolic hypertension. Further investigation is required into the intriguing suggestion that early life nutritional imbalance may adversely influence vascular angiogenesis leading to rarefaction and increased peripheral vascular resistance.
Endothelial dysfunction, HDL cholesterol, nitric oxide synthase gene, C reactive protein, Vascular Compliance
Maternal and Fetal Research Unit, KCL Division of Reproductive Health, Endocrinology and Development, St. Thomas' Hospital, London SE1 7EH, United Kingdom.