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The programming of cardiovascular disease

Part of: Sir David Barker Symposium

Published online by Cambridge University Press:  15 July 2015

K. L. Thornburg
K. L. Thornburg*
Affiliation:
Oregon Health & Science University, Heart Research Center, Portland, OR, USA
*
* Address of correspondence: K. L. Thornburg, Center for Developmental Health, Knight Cardiovascular Institute, School of Medicine, Oregon Health & Science University, 3303 SW Bond Avenue, OR 97239, Portland.(Email [email protected])
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Abstract

In spite of improving life expectancy over the course of the previous century, the health of the U.S. population is now worsening. Recent increasing rates of type 2 diabetes, obesity and uncontrolled high blood pressure predict a growing incidence of cardiovascular disease and shortened average lifespan. The daily >$1billion current price tag for cardiovascular disease in the United States is expected to double within the next decade or two. Other countries are seeing similar trends. Current popular explanations for these trends are inadequate. Rather, increasingly poor diets in young people and in women during pregnancy are a likely cause of declining health in the U.S. population through a process known as programming. The fetal cardiovascular system is sensitive to poor maternal nutritional conditions during the periconceptional period, in the womb and in early postnatal life. Developmental plasticity accommodates changes in organ systems that lead to endothelial dysfunction, small coronary arteries, stiffer vascular tree, fewer nephrons, fewer cardiomyocytes, coagulopathies and atherogenic blood lipid profiles in fetuses born at the extremes of birthweight. Of equal importance are epigenetic modifications to genes driving important growth regulatory processes. Changes in microRNA, DNA methylation patterns and histone structure have all been implicated in the cardiovascular disease vulnerabilities that cross-generations. Recent experiments offer hope that detrimental epigenetic changes can be prevented or reversed. The large number of studies that provide the foundational concepts for the developmental origins of disease can be traced to the brilliant discoveries of David J.P. Barker.

Keywords

epigeneticsfetal programmingheart diseaseroots of cardiovascular diseaseworsening health
Type
Review
Information
Journal of Developmental Origins of Health and Disease , Volume 6 , Issue 5: Themed Issue: David Barker commemorative meeting, September 2014; Prenatal Exposures and Health Outcomes , October 2015 , pp. 366 - 376
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Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2015 

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