274835 Developmental Origins of Heart Disease

Wednesday, October 31, 2012 : 8:30 AM - 8:50 AM

Kurt Thornburg, PhD , Heart Research Center, Oregon Health & Science University; Moore Institute for Nutrition and Wellness, Portland, OR
In 1989 David Barker showed that the risk of dying from ischemic heart disease was inversely related to birthweight in 15,000 English men and women born in Hertfordshire. Those data also showed an upward trend in risk for babies born larger than 9.5 pounds. The process by which prenatal nutritional stress leads to later cardiovascular disease is called “programming” or “the developmental origins of health and disease” and is driven by two mechanisms, structural changes in fetal organs and epigenetic modification of genes related to organ function. Programming begins at conception and continues through the first 1000 days. Poor growth in the womb is associated with detrimental changes in immune function, antioxidant systems and stem cell function. These are manifest as later risk factors including dyslipidemias, hypercoagulability, hypertension and endothelial dysfunction. Recent population data from Helsinki show that maternal body composition and maternal diet in combination with placental structure, predict coronary heart disease, heart failure and sudden death-- the three primary causes of cardiac death. The number of cardiomyocytes and coronary architectural arrangement in the adult heart are determined by oxygen, hormonal and hemodynamic conditions in the fetus. The maternofetal transport of nutrients related to cardiovascular development is sex specific and related to maternal weight gain in early pregnancy and maternal BMI. The sum of the intrauterine environmental conditions, including nutrient and cortisol levels, sets a trajectory for adult onset heart and blood vessel disease, including stroke as a cause of death in large numbers of people around the world.

Learning Areas:
Basic medical science applied in public health
Chronic disease management and prevention
Planning of health education strategies, interventions, and programs

Learning Objectives:
Participants will be able to: Identify epidemiological findings that support the developmental origins of health and disease. Describe the primary processes of programming that lead to adult-onset cardiovascular disease. Discuss the changes in the fetal body that might predispose a person the heart disease in later life. Differentiate the nutritional transport properties of the placenta that are sex specific.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have conducted NIH supported research on the fetal origins of late onset disease for the past 15 years, especially as it pertains to heart muscle and placental transport. I have participated in epidemiological studies of various adult onset diseases and their relationships to maternal, fetal and placental phenotype.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.