The effect of maternal health, fetal size and early childhood growth on cardiovascular (CVS) development in Nigerian children. (360G-Wellcome-080723_Z_06_Z)

In Nigeria, there is an escalating frequency of hypertension. Mortality from cardiovascular (CVS) causes is expected to rise to 70% in adults by the year 2020. It is not clear why this is happening, although improvements in lifestyle are recognised It is recognised in many studies worldwide that thereis an inverse relationship between birth weight and blood pressure. Furthermore malaria, which is still hyperendemic and common in pregnant women,causes maternal anemia and low birth-weight which, as in many experimental models, may predispose to increased vascular disease in the offspring. Consequently, we aim to test in Nigerian infants hypotheses that will examine the relationships between malaria in pregnancy, size at birth and early growthpatterns (in particular 'catch-up growth') on blood pressure and aortic pulse wave velocity (as a measure of vascular distensibility) at 2 years of age. We will also measure insulin, insulin-like growth factors and inflammatory markers in the first years of life as possible mediators of CVS development. This study should indicate whether adverse trends in CVS development are occurring in early life in Nigeria and help to develop effective preventive strategies with available limited resources.