Developmental programming and hypertension

Curr Opin Nephrol Hypertens. 2009 Mar;18(2):144-52. doi: 10.1097/MNH.0b013e328326092c.

Abstract

Purpose of review: There is a growing body of evidence linking adverse events or exposures during early life and adult-onset diseases. After important epidemiological studies from many parts of the world, research now focuses on mechanisms of organ dysfunction and on refining the understanding of the interaction between common elements of adverse perinatal conditions, such as nutrition, oxidants, and toxins exposures. This review will focus on advances in our comprehension of developmental programming of hypertension.

Recent findings: Recent studies have unraveled important mechanisms of oligonephronia and impaired renal function, altered vascular function and structure as well as sympathetic regulation of the cardiovascular system. Furthermore, interactions between prenatal insults and postnatal conditions are the subject of intensive research. Prematurity vs. intrauterine growth restriction modulate differently programming of high blood pressure. Along with antenatal exposure to glucocorticoids and imbalanced nutrition, a critical role for perinatal oxidative stress is emerging.

Summary: While the complexity of the interactions between antenatal and postnatal influences on adult blood pressure is increasingly recognized, the importance of postnatal life in (positively) modulating developmental programming offers the hope of a critical window of opportunity to reverse programming and prevent or reduce related adult-onset diseases.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Birth Weight
  • Blood Vessels / pathology
  • Blood Vessels / physiology
  • Disease Susceptibility
  • Female
  • Fetal Development / physiology*
  • Fetus / drug effects
  • Glucocorticoids / pharmacology
  • Gonadal Steroid Hormones / physiology
  • Humans
  • Hypertension / etiology*
  • Kidney / innervation
  • Models, Animal
  • Nephrons / physiology
  • Pregnancy
  • Premature Birth / physiopathology
  • Prenatal Nutritional Physiological Phenomena
  • Sodium Chloride, Dietary / pharmacology

Substances

  • Glucocorticoids
  • Gonadal Steroid Hormones
  • Sodium Chloride, Dietary