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Cardiovascular reactivity to psychological stressors in late adulthood is predicted by gestational age at birth

Journal of Human Hypertension volume 21, pages 401–410 (2007)Cite this article

Abstract

The relationships of body size and gestational age at birth with adult blood pressure (BP) are relatively modest compared to their stronger associations with cardiovascular disease. BP reactivity is a strong predictor of cardiovascular morbidity, and it is possible that reactivity, rather than resting level, is determined in utero. We investigated whether body size and gestational age at birth predict BP reactivity during experimentally induced psychosocial stress in late adulthood. A total of 73 men and 80 women born after 36 weeks’ gestation in Helsinki, Finland, during 1934–1944 underwent the Trier Social Stress Test (TSST); a standardized psychosocial stress test consisting of a public speech and an arithmetic task. Changes in BP were monitored continuously by a non-invasive finger photoplethysmography (Finometer, FMS, Amsterdam, The Netherlands). The results showed that the most robust early determinant of BP reactivity was gestational age; however, with opposite relationships between the sexes (P for interaction <0.001). A 1-week increase in gestational age was associated with a 3.1 mm Hg (95% confidence interval (CI), 0.2 to 6.0) and 1.2 mm Hg (95% CI, −0.1 to 2.6) decreases in systolic and diastolic BP reactivity in women, but with 5.2 mm Hg (95% CI, 1.9 to 8.4) and 2.3 mm Hg (95% CI, 0.9 to 3.8) increases in men. In conclusion, normal variation in gestational age at birth predicts cardiovascular stress reactivity in later adulthood. Given that hypothalamic–pituitary–adrenal axis contributes to the regulation of autonomic nervous system function and the timing of parturition, and shows well-established sex differences, we speculate a role for early programming of this axis in explaining the findings.

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Acknowledgements

We thank staff at the National Public Health Institute and the Department of Psychology, University of Helsinki, for excellent technical assistance and for their time in the TSST committee. The study was supported by grants from the University of Helsinki, Academy of Finland, British Heart Foundation, Finnish Foundation for Cardiovascular Research, Finnish Foundation for Pediatric Research, Finnish Diabetes Foundation, Finnish Medical Societies (Duodecim and Finska Läkaresällskapet), Helsinki University Central Hospital Research Fund, Juho Vainio Foundation, Novo Nordisk Foundation, Päivikki and Sakari Sohlberg Foundation, Signe and Ane Gyllenberg Foundation and Yrjö Jahnsson Foundation. There were no conflicts of interest.

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Authors and Affiliations

  1. Department of Psychology, University of Helsinki, Helsinki, Finland

    K Feldt & K Räikkönen

  2. Department of Health Promotion and Chronic Disease Prevention, National Public Health Institute, Helsinki, Finland

    J G Eriksson & E Kajantie

  3. Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland

    S Andersson & E Kajantie

  4. MRC Epidemiology Resource Centre, University of Southampton, Southampton, UK

    C Osmond & D I W Phillips

  5. Developmental Origins of Adult Health and Disease Centre, University of Southampton, Southampton, UK

    D J P Barker

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Correspondence to E Kajantie.

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Feldt, K., Räikkönen, K., Eriksson, J. et al. Cardiovascular reactivity to psychological stressors in late adulthood is predicted by gestational age at birth. J Hum Hypertens 21, 401–410 (2007). https://doi.org/10.1038/sj.jhh.1002176

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