Birth characteristics and risk of high systolic blood pressure in early adulthood - Socioeconomic factors and familial effects

Background: Although an inverse association between size at birth and blood pressure has been found in several studies, few studies have adjusted for the influence of socioeconomic and familial effects. Methods: We investigated whether the association between birth weight and systolic blood pressure in young men is confounded by socioeconomic factors in adolescence or familial factors (ie, common genes and shared environment). Our population-based cohort study comprised 330,768 Swedish men born between 1973 and 1981, and conscripted for military service between 1991 and 2000. The analyses of family effects were restricted to 89,856 siblings from the initial cohort. A high systolic blood pressure at conscription was defined as a systolic blood pressure >= 140 mm Hg. Birth weight for gestational age <-2 standard deviation scores was considered "light for gestational age." Results: Compared with men who had normal birth weight for gestational age, men who had been born light for gestational age were at increased risk of high systolic blood pressure (odds ratio = 1.14; 95% confidence interval = 1.07-1.22), even after adjustment for important confounders such as socioeconomic status. The increase in risk of high systolic blood pressure related to I standard deviation score decrease in birth weight for gestational age was similar within families (1.08; 1.04-1.12) and between families (1.05; 1.03-1.08). Conclusions: This study suggests that low birth weight for gestational age slightly increases the risk of high systolic blood pressure, and that the association appears not to be confounded by socioeconomic or familial effects.