The Barker hypothesis revisited

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The Barker hypothesis indicates that infants who are small at birth are at higher risk of increased blood pressure and other adverse cardiovascular endpoints later in life. In this issue of The Journal, Belfort et al examine the impact of birthweight and infant growth during the first 6 months of life on blood pressure at 3 years of age. They found that a more rapid increase in weight for length, indicating a greater increase in adiposity, during the first 6 months is associated with higher blood pressure at age 3 years. This was particularly true for infants who were thin at birth. These findings suggest that intrauterine factors may combine with postnatal weight gain to influence subsequent blood pressure and offers a possible extension to the original Barker hypothesis. The mechanisms by which these factors might operate need further investigation.

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