The impact of birth weight on cardiovascular disease risk in the Women's Health Initiative

C. J. Smith; K. K. Ryckman; V. M. Barnabei; B. V. Howard; C. R. Isasi; G. E. Sarto; S. E. Tom; L. V. Van Horn; R. B. Wallace; J. G. Robinson

doi:10.1016/j.numecd.2015.10.015

The impact of birth weight on cardiovascular disease risk in the Women's Health Initiative

C. J. Smith, K. K. Ryckman, V. M. Barnabei, B. V. Howard, C. R. Isasi, G. E. Sarto, S. E. Tom, L. V. Van Horn, R. B. Wallace, J. G. Robinson^*

^*Corresponding author for this work

Preventive Medicine

Research output: Contribution to journal › Article › peer-review

75 Scopus citations

Abstract

Background and aims: Cardiovascular disease (CVD) is among the leading causes of morbidity and mortality worldwide. Traditional risk factors predict 75-80% of an individual's risk of incident CVD. However, the role of early life experiences in future disease risk is gaining attention. The Barker hypothesis proposes fetal origins of adult disease, with consistent evidence demonstrating the deleterious consequences of birth weight outside the normal range. In this study, we investigate the role of birth weight in CVD risk prediction. Methods and results: The Women's Health Initiative (WHI) represents a large national cohort of post-menopausal women with 63,815 participants included in this analysis. Univariable proportional hazards regression analyses evaluated the association of 4 self-reported birth weight categories against 3 CVD outcome definitions, which included indicators of coronary heart disease, ischemic stroke, coronary revascularization, carotid artery disease and peripheral arterial disease. The role of birth weight was also evaluated for prediction of CVD events in the presence of traditional risk factors using 3 existing CVD risk prediction equations: one body mass index (BMI)-based and two laboratory-based models. Low birth weight (LBW) (<6 lbs.) was significantly associated with all CVD outcome definitions in univariable analyses (HR = 1.086, p = 0.009). LBW was a significant covariate in the BMI-based model (HR = 1.128, p < 0.0001) but not in the lipid-based models. Conclusion: LBW (<6 lbs.) is independently associated with CVD outcomes in the WHI cohort. This finding supports the role of the prenatal and postnatal environment in contributing to the development of adult chronic disease.

Original language	English (US)
Pages (from-to)	239-245
Number of pages	7
Journal	Nutrition, Metabolism and Cardiovascular Diseases
Volume	26
Issue number	3
DOIs	https://doi.org/10.1016/j.numecd.2015.10.015
State	Published - Mar 1 2016

Funding

This work was supported by a K99/R00 grant from the National Institute of Child Health and Human Development [ R00 HD-065786 ]. We would like to acknowledge the WHI Program Office, specifically Jacques Rossouw, Shari Ludlam, Dale Burwen, Joan McGowan, Leslie Ford, and Nancy Geller ( National Heart, Lung, and Blood Institute , Bethesda, Maryland). Also individuals at the WHI Clinical Coordinating Center Garnet Anderson, Ross Prentice, Andrea LaCroix, and Charles Kooperberg ( Fred Hutchinson Cancer Research Center , Seattle, WA). Investigators and Academic Centers contributing to WHI science include: JoAnn E. Manson ( Brigham and Women's Hospital , Harvard Medical School , Boston, MA); Barbara V. Howard (MedStar Health Research Institute/Howard University, Washington, DC); Marcia L. Stefanick (Stanford Prevention Research Center, Stanford, CA); Rebecca Jackson (The Ohio State University , Columbus, OH); Cynthia A. Thomson (University of Arizona, Tucson/Phoenix, AZ); Jean Wactawski-Wende (University at Buffalo, Buffalo, NY); Marian Limacher (University of Florida, Gainesville/Jacksonville, FL); Robert Wallace (University of Iowa, Iowa City/Davenport, IA); Lewis Kuller (University of Pittsburgh, Pittsburgh, PA); Sally Shumaker ( Wake Forest University School of Medicine, Winston–Salem, NC). The WHI programs is funded by the National Heart, Lung, and Blood Institute , National Institutes of Health , U.S. Department of Health and Human Services through contracts, HHSN268201100046C , HHSN268201100001C , HHSN268201100002C , HHSN268201100003C , HHSN268201100004C . We would like to acknowledge the WHI Program Office, specifically Jacques Rossouw, Shari Ludlam, Dale Burwen, Joan McGowan, Leslie Ford, and Nancy Geller (National Heart, Lung, and Blood Institute, Bethesda, Maryland). Also individuals at the WHI Clinical Coordinating Center Garnet Anderson, Ross Prentice, Andrea LaCroix, and Charles Kooperberg (Fred Hutchinson Cancer Research Center, Seattle, WA). Investigators and Academic Centers contributing to WHI science include: JoAnn E. Manson (Brigham and Women''s Hospital, Harvard Medical School, Boston, MA); Barbara V. Howard (MedStar Health Research Institute/Howard University, Washington, DC); Marcia L. Stefanick (Stanford Prevention Research Center, Stanford, CA); Rebecca Jackson (The Ohio State University, Columbus, OH); Cynthia A. Thomson (University of Arizona, Tucson/Phoenix, AZ); Jean Wactawski-Wende (University at Buffalo, Buffalo, NY); Marian Limacher (University of Florida, Gainesville/Jacksonville, FL); Robert Wallace (University of Iowa, Iowa City/Davenport, IA); Lewis Kuller (University of Pittsburgh, Pittsburgh, PA); Sally Shumaker (Wake Forest University School of Medicine, Winston–Salem, NC). The WHI programs is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services through contracts, HHSN268201100046C, HHSN268201100001C, HHSN268201100002C, HHSN268201100003C, HHSN268201100004C. This work was supported by a K99/R00 grant from the National Institute of Child Health and Human Development [R00 HD-065786].

Keywords

Barker hypothesis
Life course epidemiology
Metabolic syndrome
Proportional hazards model
Risk prediction
Self-reported birth weight

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine
Nutrition and Dietetics
Medicine (miscellaneous)
Endocrinology, Diabetes and Metabolism

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.numecd.2015.10.015

Cite this

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title = "The impact of birth weight on cardiovascular disease risk in the Women's Health Initiative",

abstract = "Background and aims: Cardiovascular disease (CVD) is among the leading causes of morbidity and mortality worldwide. Traditional risk factors predict 75-80% of an individual's risk of incident CVD. However, the role of early life experiences in future disease risk is gaining attention. The Barker hypothesis proposes fetal origins of adult disease, with consistent evidence demonstrating the deleterious consequences of birth weight outside the normal range. In this study, we investigate the role of birth weight in CVD risk prediction. Methods and results: The Women's Health Initiative (WHI) represents a large national cohort of post-menopausal women with 63,815 participants included in this analysis. Univariable proportional hazards regression analyses evaluated the association of 4 self-reported birth weight categories against 3 CVD outcome definitions, which included indicators of coronary heart disease, ischemic stroke, coronary revascularization, carotid artery disease and peripheral arterial disease. The role of birth weight was also evaluated for prediction of CVD events in the presence of traditional risk factors using 3 existing CVD risk prediction equations: one body mass index (BMI)-based and two laboratory-based models. Low birth weight (LBW) (<6 lbs.) was significantly associated with all CVD outcome definitions in univariable analyses (HR = 1.086, p = 0.009). LBW was a significant covariate in the BMI-based model (HR = 1.128, p < 0.0001) but not in the lipid-based models. Conclusion: LBW (<6 lbs.) is independently associated with CVD outcomes in the WHI cohort. This finding supports the role of the prenatal and postnatal environment in contributing to the development of adult chronic disease.",

keywords = "Barker hypothesis, Life course epidemiology, Metabolic syndrome, Proportional hazards model, Risk prediction, Self-reported birth weight",

author = "Smith, {C. J.} and Ryckman, {K. K.} and Barnabei, {V. M.} and Howard, {B. V.} and Isasi, {C. R.} and Sarto, {G. E.} and Tom, {S. E.} and {Van Horn}, {L. V.} and Wallace, {R. B.} and Robinson, {J. G.}",

note = "Publisher Copyright: {\textcopyright} 2015 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University.",

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doi = "10.1016/j.numecd.2015.10.015",

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T1 - The impact of birth weight on cardiovascular disease risk in the Women's Health Initiative

AU - Smith, C. J.

AU - Ryckman, K. K.

AU - Barnabei, V. M.

AU - Howard, B. V.

AU - Isasi, C. R.

AU - Sarto, G. E.

AU - Tom, S. E.

AU - Van Horn, L. V.

AU - Wallace, R. B.

AU - Robinson, J. G.

N1 - Publisher Copyright: © 2015 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University.

PY - 2016/3/1

Y1 - 2016/3/1

N2 - Background and aims: Cardiovascular disease (CVD) is among the leading causes of morbidity and mortality worldwide. Traditional risk factors predict 75-80% of an individual's risk of incident CVD. However, the role of early life experiences in future disease risk is gaining attention. The Barker hypothesis proposes fetal origins of adult disease, with consistent evidence demonstrating the deleterious consequences of birth weight outside the normal range. In this study, we investigate the role of birth weight in CVD risk prediction. Methods and results: The Women's Health Initiative (WHI) represents a large national cohort of post-menopausal women with 63,815 participants included in this analysis. Univariable proportional hazards regression analyses evaluated the association of 4 self-reported birth weight categories against 3 CVD outcome definitions, which included indicators of coronary heart disease, ischemic stroke, coronary revascularization, carotid artery disease and peripheral arterial disease. The role of birth weight was also evaluated for prediction of CVD events in the presence of traditional risk factors using 3 existing CVD risk prediction equations: one body mass index (BMI)-based and two laboratory-based models. Low birth weight (LBW) (<6 lbs.) was significantly associated with all CVD outcome definitions in univariable analyses (HR = 1.086, p = 0.009). LBW was a significant covariate in the BMI-based model (HR = 1.128, p < 0.0001) but not in the lipid-based models. Conclusion: LBW (<6 lbs.) is independently associated with CVD outcomes in the WHI cohort. This finding supports the role of the prenatal and postnatal environment in contributing to the development of adult chronic disease.

AB - Background and aims: Cardiovascular disease (CVD) is among the leading causes of morbidity and mortality worldwide. Traditional risk factors predict 75-80% of an individual's risk of incident CVD. However, the role of early life experiences in future disease risk is gaining attention. The Barker hypothesis proposes fetal origins of adult disease, with consistent evidence demonstrating the deleterious consequences of birth weight outside the normal range. In this study, we investigate the role of birth weight in CVD risk prediction. Methods and results: The Women's Health Initiative (WHI) represents a large national cohort of post-menopausal women with 63,815 participants included in this analysis. Univariable proportional hazards regression analyses evaluated the association of 4 self-reported birth weight categories against 3 CVD outcome definitions, which included indicators of coronary heart disease, ischemic stroke, coronary revascularization, carotid artery disease and peripheral arterial disease. The role of birth weight was also evaluated for prediction of CVD events in the presence of traditional risk factors using 3 existing CVD risk prediction equations: one body mass index (BMI)-based and two laboratory-based models. Low birth weight (LBW) (<6 lbs.) was significantly associated with all CVD outcome definitions in univariable analyses (HR = 1.086, p = 0.009). LBW was a significant covariate in the BMI-based model (HR = 1.128, p < 0.0001) but not in the lipid-based models. Conclusion: LBW (<6 lbs.) is independently associated with CVD outcomes in the WHI cohort. This finding supports the role of the prenatal and postnatal environment in contributing to the development of adult chronic disease.

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KW - Metabolic syndrome

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KW - Risk prediction

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The impact of birth weight on cardiovascular disease risk in the Women's Health Initiative

Abstract

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Keywords

ASJC Scopus subject areas

UN SDGs

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