Severe malnutrition in childhood (before age 5) may increase the risk for high blood pressure in adulthood — a possible significant impact on global health, according to new research in the American Heart Association journal Hypertension.

Inadequate nutrition before birth and up to age 5 may harm the heart's development, researchers said.

"If nutritional needs are not met during this time, when structures of the body are highly susceptible to potentially irreversible change, it could have long-term consequences on heart anatomy and blood flow later in life," said Terrence Forrester, Ph.D., study senior author and chief scientist, UWI Solutions for Developing Countries, at the University of the West Indies, Mona, in Kingston, Jamaica.

"We are concerned that millions of people globally who suffer malnutrition before or after birth are at increased risk of hypertension in later life," Forrester said.

Researchers compared 116 adults (mean age 28.8 years, 55% male) who endured malnutrition growing up in Jamaica to 45 men and women who were adequately fed as children. The participants, most in their 20s and 30s, were measured for height, weight and blood pressure levels, and underwent echocardiograms to evaluate heart function.

Compared with those who weren't malnourished, adults who survived early childhood malnutrition had:

• Higher diastolic blood pressure readings (P=0.007)
• Higher peripheral resistance (P<0.0001)
• Poorer heart function (smaller left ventricular outflow tract, stroke volume and cardiac output)

These factors all point to an increased risk for hypertension, a major risk factor for heart disease and stroke.

The authors warn that inadequate nutrition before birth and up to age 5 may have long-term cardiovascular consequences for the many people in the world who have experienced severe childhood malnutrition. Addressing malnutrition comprehensively could help prevent and manage hypertension, Forrester said.

"Such an investment in nutrition and general health will have huge public health dividends, including these longer-term risks of chronic heart and metabolic diseases that cost so much in human lives," he said.

Co-authors are Ingrid A. Tennant; Alan T. Barnett; Debbie S. Thompson; Jan Kips; Michael S. Boyne; Edward E. Chung; Andrene P. Chung; Clive Osmond; Mark A. Hanson; Peter D. Gluckman; Patrick Segers; and J. Kennedy Cruickshank. Author disclosures are on the manuscript.

 The New Zealand Health Research Council funded the study.