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Hypertension less common among childhood survivors of Chinese famine
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A cohort of adults who were children during the Chinese famine of 1959 to 1961 had lower rates of hypertension compared with adults who did not experience the famine directly, according to findings published in Nutrition, Metabolism & Cardiovascular Diseases.
“The association of famine with the incidence of hypertension has remained controversial, the main reason for this being the fact that most findings from the published Chinese famine studies might be confounded by age,” Chen Yongjie, PhD, from the department of epidemiology and statistics in the School of Public Health at Tianjin Medical University in China, and colleagues wrote. “[We] aimed to examine the association of exposure to Chinese famine in early life with the incidence of hypertension in adulthood, which would allow the identification of individuals who may benefit more from targeted management and screening of hypertension among the famine survivors.”
Using data from the China Health and Nutrition Survey, Yongjie and colleagues identified 6,914 adults (mean age, 36.94 years; 50.97% women) born between 1949 and 1965 who may have directly or indirectly experienced effects of the Chinese famine of 1959 to 1961. Records from the survey provided information on weight, height, smoking and drinking practices and blood pressure, with the researchers setting thresholds of at least 140 mm Hg of systolic blood pressure and at least 90 mm Hg of diastolic BP for hypertension diagnosis.
Participants born between 1959 and 1961, who likely had fetal exposure to the famine, according to the researchers, were less likely to have hypertension in adulthood than those who were born after the famine (adjusted HR = 0.791; 95% CI, 0.68-0.92), particularly men born in this time frame (aHR = 0.728; 95% CI, 0.591-0.896).
Hypertension risk in adulthood was also lower for those who were born between 1956 and 1958, who likely had early childhood exposure to the famine, compared with children born after the famine (aHR = 0.76; 95% CI, 0.661-0.873), although this reduction was significant only for men (aHR = 0.652; 95% CI, 0.537-0.792).
According to the researchers, the famine occurred in mid-childhood if a participant was born between 1953 and 1955, and these participants were at reduced risk for hypertension in adulthood compared with those born after the famine, between 1962 and 1965 (aHR = 0.71; 95% CI, 0.613-0.822). Only men exhibited a statistically significant decreased risk (aHR = 0.62; 95% CI, 0.505-0.76).
When participants experienced the famine in late childhood (those born between 1949 and 1952), they were also at increased risk for adult-onset hypertension (aHR = 0.613; 95% CI, 0.523-0.718) regardless of whether they were men (aHR = 0.522; 95% CI, 0.419-0.65) or women (aHR = 0.733; 95% CI, 0.579-0.929) compared with those born between 1962 and 1965.
The researchers noted that being from a rural area was associated with adult-onset hypertension for children of all levels of famine exposure (P < .001 for all) except for those born from 1962 and onward. A similar finding was observed for those from urban areas (P < .001), except for those born after 1959. – by Phil Neuffer
Disclosures: The authors report no relevant financial disclosures.
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