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There is considerable evidence that early life exposures influence later blood pressure1 and the disease end point most strongly associated with blood pressure—haemorrhagic stroke—is also related to indicators of early life adversity.2 In particular, the number of siblings that a person had was positively associated with haemorrhagic stroke risk.2 A small case-control study found that an infant or perinatal death in one or more siblings was associated with increased risk of stroke.3 Both haemorrhagic stroke4 and blood pressure5 declined across the 20th century in developed countries, and both show cohort effects, such that each subsequent birth cohort has lower haemorrhagic stroke risk and lower levels of blood pressure than previous birth cohorts.5 Across countries infant mortality rates 70 years ago correlate strongly with current stroke mortality.6 One early life factor that would be related to all these indicators of early life exposure is infant diarrhoea. We postulate that severe dehydrating diarrhoea in infancy is associated with higher subsequent blood pressure.
METHODS AND RESULTS
Funding: this study would not have been undertaken without the financial support of the Medical Research Council, the Wellcome Trust, the UK Department of Health, the Department of the Environment, the DfEE, the National Institutes of Health, and a variety of medical research charities and commercial companies. ALSPAC is part of the World Health Organisation-initiated European longitudinal study of parents and children.
Competing interests: none declared.
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