Exploring the relationship between early life exposures and the comorbidity of obesity and hypertension: findings from the 1970 the British cohort study (BCS70)

Abstract

Background: epidemiological research commonly investigates single exposure-outcome relationships, while children’s experiences across a variety of early lifecourse domains are intersecting. To design realistic interventions, epidemiological research should incorporate information from multiple risk exposure domains to assess effect on health outcomes. In this paper we identify exposures across five pre-hypothesised childhood domains and explored their association to the odds of combined obesity and hypertension in adulthood.

Methods: we used data from 17,196 participants in the 1970 British Cohort Study. The outcome was obesity (BMI of ≥30) and hypertension (blood pressure>140/90mm Hg or self-reported doctor’s diagnosis) comorbidity at age 46. Early life domains included: ‘prenatal, antenatal, neonatal and birth’, ‘developmental attributes and behaviour’, ‘child education and academic ability’, ‘socioeconomic factors’ and ‘parental and family environment’. Stepwise backward elimination selected variables for inclusion for each domain. Predicted risk scores of combined obesity and hypertension for each cohort member within each domain were calculated. Logistic regression investigated the association between domain-specific risk scores and odds of obesity-hypertension, controlling for demographic factors and other domains.

Results: adjusting for demographic confounders, all domains were associated with odds of obesity-hypertension. Including all domains in the same model, higher predicted risk values across the five domains remained associated with increased odds of obesity-hypertension comorbidity, with the strongest associations to the parental and family environment domain (OR1.11 95%CI 1.05-1.18) and the socioeconomic factors domain (OR1.11 95%CI 1.05-1.17).

Conclusions: targeted prevention interventions aimed at population groups with shared early-life characteristics could have an impact on obesity-hypertension prevalence which are known risk factors for further morbidity including cardiovascular disease.

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Identifiers

ORCID for S. Stannard: orcid.org/0000-0002-6139-1020

ORCID for A. Berrington: orcid.org/0000-0002-1683-6668

ORCID for N. Ziauddeen: orcid.org/0000-0002-8964-5029

ORCID for S.D.S. Fraser: orcid.org/0000-0002-4172-4406

ORCID for R.B. Hoyle: orcid.org/0000-0002-1645-1071

ORCID for N.A. Alwan: orcid.org/0000-0002-4134-8463

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