PERINANTAL PROGRAMMING OF ARTERIAL HYPERTENSION IN CHILD

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Abstract

There is a growing number of evidence linking fetal intrauterine malnutrition, other adverse events or exposures and arterial hypertension during the following life. After important epidemiological studies from many countries, research now focuses on mechanisms of organ dysfunction and on refining the understanding of the interaction between common elements of adverse perinatal conditions and normal development. This review focused  on advances in comprehension of the influence of intrauterine malnutrition on developmental programming of hypertension. Significant decrease in nephrons number was demonstrated as a result of fetal asymmetrical growth restriction syndrome both in human and experimental animal model. The role of malnutrition and dexametasone induced rennin-angiotensin system inhibition in fetal and newborn nephrogenesis is discussed. Recent studies have revealed  important mechanisms of  altered vascular function and structure as well as sympathetic regulation of the cardiovascular system in perinatal hypertension models. Some of adverse effects on nephrogenesis and blood pressure regulation could be reversed by special diet and treatment during first two years of life. While the complexity of the interactions between antenatal and postnatal influences on blood pressure is increasingly recognized, the importance of early postnatal life in modulating developmental programming offers the hope of a critical 1000 days  window of opportunity to reverse programming and prevent or reduce child hypertension.

 

About the authors

O. P. Kovtun

Ural State Medical Academy, Yekaterinburg, Russian Federation

Author for correspondence.
Email: usma@usma.ru
PhD, Professor, Head of the Department of Pediatrics Faculty of Advanced Medical Studies, Provost for Research of Ural State Medical Academy Address: 620028, Moscow, Repin Street 3; tel.: (343) 214-86-79 Russian Federation

P. B. Tsyv'yan

Ural State Medical Academy, Yekaterinburg, Russian Federation
Mother and Child Research Institute, Yekaterinburg, Russian Federation
Institute of Immunology and Physiology Ural branch of RAS, Yekaterinburg, Russian Federation

Email: tsyvian@hotbox.ru
PhD, Professor, Head of the Department of Normal Physiology Ural State Medical Academy, Leading Research Worker of Ural Scientific and Research Institute of Maternity and Child, Senior Research Worker of Institute of Immunology and Physiology Ural Branch RAS. Address: 620028, Moscow, Repin Street 3; tel.: (343) 214-85-56 Russian Federation

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