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Title: Abnormalities of cardiovascular structure as mediators of the association of high blood pressure, insulin resistance and low birthweight
Author: Irving, Robert John
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 2002
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Many studies have demonstrated associations between low birthweight and higher subsequent blood pressure, insulin resistance and greater incidence of coronary heart disease. These findings suggest that the origins of vascular disease are to be found during intra-uterine life, and that the low birthweight individual may be “programmed” to develop vascular disease. The introduction to this thesis reviews key papers describing associations between early life and adult cardiovascular risk factors. Factors that alter birthweight are considered in detail, especially the effect of gestational age, which has been relatively neglected in previously published work. The chapter concludes with a review of the field of microvascular structure and hypertension. The experimental chapters describe studies performed in three cohorts of healthy young people. The first cohort comprises 61 survivors of premature delivery or control individuals born at term. We demonstrated higher adult blood pressure, glucose and lipids in adult premature babies irrespective of whether they had been exposed to IUGR. Chapter 3 documents indices of cardiac and vascular structure in this cohort. We demonstrated that low birthweight in this cohort was associated with greater left ventricular mass, over and above the effect from the higher blood pressure in these individuals. Chapter 4 describes the influence of birthweight, current size and parental size on blood pressure in a cohort of 107 boys attending a fee-paying school. Low birthweight is associated with higher blood pressure after adjustment for current size, but is not associated with parental influence on current size. We also measured dermal capillary density in these boys but did not demonstrate associations with blood pressure or birthweight. Chapter 5 investigates associations between structure and function of microvessels, and blood pressure, insulin resistance and fasting plasma glucose concentrations in 105 healthy young men. We did not find evidence that insulin resistance was associated with altered structure or function of microvessels, although both higher blood pressure and higher blood glucose were associated with capillary rarefaction. The thesis concludes with a brief overview of conclusions and speculations.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available