Origins of Disparities in Cardiovascular Disease: Birth Weight, Body Mass Index, and Young Adult Systolic Blood Pressure in the National Longitudinal Study of Adolescent Health

Purpose We evaluated the contributions of birth weight and current body mass index (BMI) to racial/ethnic disparities in systolic blood pressure (SBP) in the United States. Methods Participants were 10,046 young adults (ages 24–32) in the National Longitudinal Study of Adolescent Health. SBP, BMI, and other contemporaneous factors were assessed at Wave IV (2007–2008); birth weight and other early life factors were reported at Wave I (1994–1995). Data were analyzed using sex- and race-stratified multivariable regression models. Results Racial/ethnic disparities in SBP were limited to black and white females. The black–white female disparity in SBP was 3.36 mmHg and was partially explained by current BMI, but not birth weight. Associations between birth weight and SBP were limited to males, in whom we found a decrease of 1.05 mmHg in SBP per 1-kg increase in birth weight (95% confidence interval, −1.90, −0.20). This inverse relationship strengthened after adjusting for BMI and other factors, and was strongest among black and white males. A significant association between BMI and SBP was found in all racial/ethnic and sex subgroups. Conclusions In this U.S. national cohort, birth weight is negatively associated with SBP among black and white young adult males.