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 Vol. 5 No. 12, December 2004
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NeoReviews Vol.5 No.12 2004 e527
© 2004 American Academy of Pediatrics

Fetal Origins of Cardiovascular Disease

Kent L. Thornburg, PhD*

* Heart Research Center, Departments of Medicine (Cardiology), Obstetrics & Gynecology and Biomedical Engineering, Oregon Health & Science University, Portland Ore

Abbreviations: h: wall thickness • NO: nitric oxide • PA: pulmonary artery • r: radius • RV: right venticle • Sw: wall stress

The first 300 words of the full text of this article appear below.


   Objectives
 
After completing this article, readers should be able to:

  1. Describe the relationship between ischemic heart disease and term birthweight.
  2. Delineate the intrauterine factors that can lead to programming and an increased risk for coronary disease and hypertension.
  3. Describe the intrauterine factors that lead to postnatal endothelial dysfunction that increases the risk for coronary disease.


   Heart Disease in Adults
 
Cardiovascular disease kills more people in western countries than any other disease. Furthermore, it now is known that women are as vulnerable to heart disease as men. In fact, the number of women living with cardiovascular disease in the United States exceeds the number of men who have the disease. In addition, the number of men and women whose lifestyles are limited due to a failing heart or other cardiovascular disability is increasing. The American Heart Association predicts that in 2004, the total cost of cardiovascular disease will exceed the cost of any other disease at about $370 billion, mostly due to heart disease. No disease takes a toll on the human population like heart disease and stroke.

Although the incidence of cardiovascular disease has decreased in the United States since about 1970, the incidence is increasing in developing countries. Heart disease and stroke accounted for the deaths of some 10 million people around the world in 2000. In upcoming decades, the burden of cardiovascular disease is expected to increase dramatically in most countries of the world. Thus, the developing world is seeing an epidemic of heart disease as was seen in the first half of the 20th century in the United States.

Cardiac scientists generally agree that pathologic change in the coronary endothelium is the common initiating feature of disease. In fact, fatty streaks on the coronary endothelium may develop even before birth in some susceptible individuals. Although there is a standard "textbook" progression of . . . [Full Text of this Article]


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