Young adults born small for gestational age: Is reduced baroreceptor sensitivity a risk factor for hypertension?

Abstract

Background: Adults born small for gestational age (SGA) are at increased risk for the metabolic syndrome and cardiovascular disease. Hypothesis: Impaired short-term blood pressure regulation may contribute to the development of hypertension in patients born SGA. Methods: In all, 43 patients born SGA (18 female, age 19.4 ± 0.3 years) were evaluated by beat-to-beat blood pressure and heart rate registration during rest and mental and orthostatic stress. The study group was divided into Group 1 with normal resting blood pressure (n = 32) and Group 2 with slightly elevated blood pressure (n = 11). Baroreceptor sensitivity (BRS) was calculated. Fasting insulin as well as lipid levels were correlated with hemodynamic parameters. Results: Eleven of the 43 study patients (25%) had a slightly elevated resting systolic blood pressure (SBP) rising during mental and orthostatic stress. Body mass index (BMI) and fasting insulin levels correlated strongly with SBP in Group 2. Baroreceptor sensitivity was lower in Group 2 at rest (p < 0.05). Conclusions: Three components of metabolic syndrome (elevated BP, high BMI, elevated insulin levels) correlate strongly in young adolescents born SGA; BRS is reduced in prehypertensive patients. Close follow-up is warranted during adult life as they are predisposed for developing a metabolic syndrome with elevated cardiovascular risk.