The effects of exposure to the Great Chinese Famine during the fetal stage and childhood on prevalence of hypertension in adulthood

Introduction Many studies have found that famine exposure in early life was associated with higher prevalence of hypertension, but the results remain controversial. The aim was to examine the association of early life exposure to famine with hypertension in adulthood. Material and methods The cross-sectional study enrolled about 100,000 adults from Guangdong province, China, who were born between 1 October 1952 and 30 September 1964. Participants were classified as non-exposed, fetal exposed, early-childhood exposed, mid-childhood exposed, and late-childhood exposed group according to birth data. Multivariable logistic regression, subgroup analysis, and sensitivity analysis were used to estimate the odds ratios (ORs) and confidence intervals (CIs) for the association between famine exposure and hypertension. Results Among the 28,804 participants, the prevalence of hypertension in non-exposed, fetal, early-childhood, mid-childhood, and late-childhood exposed groups were 2686 (41.2%), 1777 (44.5%), 2998 (49.0%), 3196 (51.1%), 3192 (53.9%), respectively. Compared with the non-exposed group, the fully adjusted ORs of subjects exposed to the famine in the fetal, early-childhood, mid-childhood and late-childhood exposed groups were 1.10 (95% CI: 0.97–1.24, p = 0.143), 1.23 (95% CI: 1.10–1.37, p < 0.001), 1.39 (95% CI: 1.24–1.55, p < 0.001), and 1.55 (95% CI: 1.38–1.73, p < 0.001), respectively (p for trend < 0.001), and for the age-balanced group it was 1.37 (95% CI: 1.13–1.59, p < 0.001). Subgroup analyses showed that the effect of famine on hypertension was more pronounced in women and in the rural and overweight population. Conclusions Exposure to famine at any stage in childhood, but not in the fetal stage, was significantly associated with higher prevalence of hypertension in adults, especially in women and in the rural and overweight population.