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Oxygen therapy, capillary rarefaction and blood pressure rise in premature low birth weight infants: is there a link?

Journal of Human Hypertension volume 33, pages 821–823 (2019)Cite this article

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Approximately 11% of all livebirths worldwide are preterm with steadily increasing trends [1]. The survival of a growing cohort of low-birth weight (LBW) infants, in particular those born preterm has led to increasing recognition of their long-term health consequences. LBW infants exhibit subclinical cardiac and vascular alterations at adolescence and adulthood and are prone to higher blood pressure (BP) and the development of hypertension and its sequelae [2, 3]. Considering the increasing portion of individuals born preterm at LBW that enters adulthood, it is critical to comprehensively identify and understand the triggers for a later increase in BP in order to prevent the detrimental cardiovascular consequences of hypertension.

Compelling clinical and experimental data suggest that intrauterine, perinatal, and neonatal influences may shape the link between preterm birth and hypertension in later life. A multitude of possible genetic and epigenetic mechanisms have been implicated, mediated by three major organs or systems: the kidney, the neuroendocrine system, and the vasculature [2]. However, capillary rarefaction (CR) has gained attention over the past few decades as a unique feature implicated in the pathogenesis of hypertension in preterm LBW individuals. CR is a hallmark of essential hypertension [4] encountered not only in hypertensive patients, but also in other high cardiovascular risk groups [5,6,7]. Antonios and his group have made an important contribution to this field. Their findings of skin CR in patients with borderline intermittent hypertension and in normotensive offspring of hypertensive parents suggest a primary role for CR as a forerunner of hypertension through altered hemodynamic responses [8, 9]. In addition, capillary density was lower in term infants born to hypertensive mothers compared with those born to normotensive mothers [10]. By contrast, they observed increased capillary density in LBW infants than their peers born at term with normal birth weight (NBW), generating new hypotheses on the exact timing of “capillary hyperpruning” in LBW individuals [11].

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Authors and Affiliations

  1. Third Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Panagiota Anyfanti, Eugenia Gkaliagkousi & Stella Douma

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  1. Panagiota Anyfanti
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  2. Eugenia Gkaliagkousi
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  3. Stella Douma
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Correspondence to Panagiota Anyfanti.

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Anyfanti, P., Gkaliagkousi, E. & Douma, S. Oxygen therapy, capillary rarefaction and blood pressure rise in premature low birth weight infants: is there a link?. J Hum Hypertens 33, 821–823 (2019). https://doi.org/10.1038/s41371-019-0258-z

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