Prenatal Alcohol Exposure and the Associated Risk of Elevated Blood Pressure: A Cross-sectional Analysis of 3- to 17-Year-Olds in Germany

Am J Hypertens. 2019 Oct 16;32(11):1118-1125. doi: 10.1093/ajh/hpz107.

Abstract

Background: As the prevalence of obesity and high blood pressure increases among the population, early action is needed to reduce blood pressure. Certain lifestyles during pregnancy have negative effects resulting in high blood pressure for children and adolescents. Using data from the "German Health Interview and Examination Survey for Children and Adolescents" (KiGGS), this study analyzed: (i) the association between low-to-moderate prenatal alcohol exposure (PAE) and the risk of increased systolic and diastolic blood pressure and (ii) whether associations were modified by socioeconomic status (SES), prenatal smoke exposure (PSE), and body mass index (BMI) of the children and adolescents.

Methods: We applied multivariate logistic regression analyses and stratified analyses by SES, PSE, and BMI with cross-sectional data from the KiGGS study (N = 14,253) to examine the association between PAE and prehypertension or hypertension in 3- to 17-year-olds.

Results: Of the surveyed children and adolescents, 13.7% had a systolic prehypertension and 11.5% had a diastolic prehypertension. A further 7.5% were identified as having systolic hypertension and 6.0% diastolic hypertension. In the regression analyses, PAE resulted in a decreased risk of systolic prehypertension (odds ratio [OR]: 0.83, 95% confidence interval [CI]: 0.70, 0.99) and diastolic prehypertension (OR: 0.82, 95% CI: 0.68, 0.98). Risk reductions were not significant in surveyed children and adolescents with hypertension. Interactions between PAE and SES, PSE, and offspring BMI were not significant.

Conclusions: Contrary to our initial hypothesis, PAE reduces the risk of prehypertension. Animal studies suggest that vasodilation is induced by nitric oxide in small quantities of PAE.

Keywords: alcohol; blood pressure; diastolic; hypertension; pregnancy; prehypertension; systolic.

MeSH terms

  • Adolescent
  • Age Factors
  • Alcohol Drinking / adverse effects*
  • Alcohol Drinking / epidemiology
  • Blood Pressure*
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Ethanol / adverse effects*
  • Female
  • Fetal Alcohol Spectrum Disorders / diagnosis
  • Fetal Alcohol Spectrum Disorders / epidemiology*
  • Fetal Alcohol Spectrum Disorders / physiopathology
  • Germany / epidemiology
  • Health Surveys
  • Humans
  • Male
  • Pediatric Obesity / epidemiology
  • Pediatric Obesity / physiopathology
  • Pregnancy
  • Prehypertension / diagnosis
  • Prehypertension / epidemiology*
  • Prehypertension / physiopathology
  • Prenatal Exposure Delayed Effects*
  • Prevalence
  • Risk Assessment
  • Risk Factors
  • Smoking / adverse effects
  • Smoking / epidemiology
  • Social Class
  • Social Determinants of Health

Substances

  • Ethanol