Cardiovascular-related diseases are the leading cause of death in the world in both men and women. In addition to the environmental and genetic factors, early life conditions are now also considered important contributing elements to these pathologies. The concept of ‘fetal’ or ‘developmental’ origins of adult diseases has received increased recognition over the last decade, yet the mechanism by which altered perinatal environment can lead to dysfunction mostly apparent in the adult are incompletely understood. This review will focus on the mechanisms and pathways that epidemiological studies and experimental models have revealed underlying the adult cardiovascular phenotype dictated by the perinatal experience, as well as the probable key causal or triggering elements. Programmed elevated blood pressure in the adult human or animal is characterized by vascular dysfunction and microvascular rarefaction. Developmental mechanisms that have been more extensively studied include glucocorticoid exposure, the role of the kidneys and the renin–angiotensin system. Other pathophysiological pathways have been explored, such as the role of the brain and the sympathetic nervous system, oxidative stress and epigenetic changes. As with many complex diseases, a unifying hypothesis linking the perinatal environment to elevated blood pressure and vascular dysfunction in later life cannot be presumed, and a better understanding of those mechanisms is critical before clinical trials of preventive or ‘deprogramming’ measures can be designed.
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January 2008
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Review Article|
November 30 2007
Mechanisms underlying developmental programming of elevated blood pressure and vascular dysfunction: evidence from human studies and experimental animal models
Anne Monique Nuyt
1Department of Pediatrics, CHU Sainte-Justine Research Center, Université de Montréal, 3175 Côte Sainte-Catherine, Montréal, Québec, Canada H3T 1C5
Correspondence: Dr Anne Monique Nuyt (email [email protected]).
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Publisher: Portland Press Ltd
Received:
April 02 2007
Revision Received:
May 17 2007
Accepted:
May 30 2007
Online ISSN: 1470-8736
Print ISSN: 0143-5221
© The Authors Journal compilation © 2008 Biochemical Society
2008
Clin Sci (Lond) (2008) 114 (1): 1–17.
Article history
Received:
April 02 2007
Revision Received:
May 17 2007
Accepted:
May 30 2007
Citation
Anne Monique Nuyt; Mechanisms underlying developmental programming of elevated blood pressure and vascular dysfunction: evidence from human studies and experimental animal models. Clin Sci (Lond) 1 January 2008; 114 (1): 1–17. doi: https://doi.org/10.1042/CS20070113
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