Symbolic representation of the link between childhood obesity and cardiovascular health.

Obesity's Hidden Link to High Blood Pressure: What Parents of Preemies Need to Know

Q: What is the Renin-Angiotensin System (RAS) and why is it relevant to premature birth and high blood pressure?

The Renin-Angiotensin System (RAS) is a critical regulator of blood pressure and overall cardiovascular function. It consists of two main pathways. One is the ACE/Ang II/Ang II type 1 receptor pathway, which increases blood pressure. The other is the ACE2/Ang-(1-7)/Mas receptor pathway, which counteracts the first by promoting vasodilation, sodium excretion, and inhibiting inflammation. Premature birth can affect the RAS, increasing the risk of chronic health conditions like hypertension. This is because events during the perinatal period can induce changes in the RAS, which may lead to a dysregulation of blood pressure control. Understanding these mechanisms is vital for preventive care in individuals born prematurely.

Q: How does obesity specifically impact the RAS and blood pressure in adolescents born prematurely?

Recent research indicates that obesity is linked to higher levels of Ang II and lower levels of Ang-(1-7). This imbalance can potentially lead to increased blood pressure in adolescents born prematurely. The study quantified plasma and urinary Ang II and Ang-(1-7) levels, comparing overweight/obese adolescents to those with a healthy BMI. The findings showed that overweight/obesity was associated with a higher ratio of plasma Ang II to Ang-(1-7), increased Ang II levels, and decreased Ang-(1-7) levels. This imbalance exacerbates the risk of high blood pressure already present in individuals born prematurely.

Q: What practical steps can parents and caregivers take to mitigate the risks of high blood pressure in preemies?

Parents and caregivers should focus on promoting healthy lifestyle habits to mitigate the risks of high blood pressure. Maintaining a healthy weight is paramount, as obesity can compound the risk of hypertension and cardiovascular disease. This includes promoting a balanced diet and encouraging regular physical activity. By focusing on these aspects, parents can help to manage and reduce the disruption in the renin-angiotensin system, supporting their child's cardiovascular health and well-being.

Q: What were the key findings of the study regarding obesity, the RAS, and blood pressure in adolescents born prematurely?

The study revealed a significant association between overweight/obesity and blood pressure in adolescents born prematurely. The key findings included that overweight/obese adolescents had higher systolic blood pressure and a greater proportion with high blood pressure. After adjusting for race and antenatal corticosteroid exposure, it was found that overweight/obesity was linked to an elevated ratio of plasma Ang II to Ang-(1-7), higher Ang II levels, and lower Ang-(1-7) levels. A similar, though less statistically significant, trend was observed in urine samples. These results underscore the disruption in the RAS caused by obesity in this population.

Q: How do race and antenatal corticosteroid exposure potentially influence the study's findings on obesity and blood pressure in preemies?

Race and antenatal corticosteroid exposure were considered as potential confounding factors in the study's analysis. The researchers accounted for these factors to ensure the observed relationship between obesity, the RAS, and blood pressure in adolescents born prematurely was accurate. It is known that both race and exposure to antenatal corticosteroids can influence the RAS. By adjusting for these factors, the study aimed to isolate the specific impact of obesity on the RAS and blood pressure, providing a more reliable understanding of the relationship between these factors. This adjustment helped to ensure the findings were not skewed by these additional variables.

Lena Kashyap in Health & Wellness June 2025 • 4 min read.

"New research uncovers how obesity may amplify the risk of high blood pressure in adolescents born prematurely, highlighting the importance of early lifestyle interventions."

The landscape of neonatal care has undergone a monumental shift, with survival rates of preterm infants soaring thanks to advancements in medical interventions. However, this triumph is tempered by the stark reality that premature birth casts a long shadow, increasing the lifetime risk of chronic health conditions like hypertension and cardiovascular disease. Understanding the mechanisms behind this elevated risk is crucial for preventative care.

At the heart of this discussion lies the Renin-Angiotensin System (RAS), a critical regulator of blood pressure and overall cardiovascular function. Perinatal events have been shown to induce changes in the RAS. In addition to the traditional angiotensin-converting enzyme (ACE)/angiotensin II (Ang II)/Ang II type 1 receptor pathway, the RAS also consists of the regulatory angiotensin-converting enzyme 2 (ACE2)/Ang-(1-7)/Mas receptor pathway, which acts in part to counteract Ang II's actions by promoting vasodilation and sodium excretion as well as inhibiting inflammation and fibrosis.

Recent studies have illuminated a concerning link between obesity and increased Ang II expression, potentially exacerbating the risk of higher blood pressure, particularly in individuals born prematurely. Given that race and antenatal corticosteroid exposure may also influence the RAS, understanding the interplay of these factors is essential. This article delves into the intricate relationship between obesity, the RAS, and blood pressure in adolescents born prematurely, offering insights for parents and caregivers.

How Obesity and Premature Birth Impact Blood Pressure

Symbolic representation of the link between childhood obesity and cardiovascular health.

A recent study published in The Journal of Pediatrics investigated the relationship between obesity, the renin-angiotensin system (RAS), and blood pressure in adolescents born prematurely. The researchers hypothesized that obesity is associated with higher levels of angiotensin II (Ang II) and lower levels of angiotensin-(1-7) in the circulation and kidneys of these adolescents, potentially leading to increased blood pressure.

The study involved a cross-sectional analysis of 175 adolescents aged 14 years who were born preterm with very low birth weight. The researchers quantified plasma and urinary Ang II and Ang-(1-7) levels, comparing these levels between subjects with overweight/obesity (body mass index ≥85th percentile) and those with a body mass index below the 85th percentile. The results were adjusted for race and antenatal corticosteroid exposure to account for potential confounding factors.

Study Design: Cross-sectional analysis of 175 adolescents born preterm.
Measurements: Plasma and urinary Ang II and Ang-(1-7) levels.
Groups: Overweight/obese (BMI ≥85th percentile) vs. non-overweight (BMI <85th percentile).
Adjustments: Accounted for race and antenatal corticosteroid exposure.

The findings revealed that overweight/obesity was associated with higher systolic blood pressure and a greater proportion with high blood pressure. After adjusting for confounders, overweight/obesity was associated with an elevated ratio of plasma Ang II to Ang-(1-7), higher Ang II levels, and lower Ang-(1-7) levels. A similar association was observed in the urine, with overweight/obesity linked to a higher ratio of urinary Ang II to Ang-(1-7), although this effect approached statistical significance.

What This Means for Parents of Preemies

This study underscores the importance of maintaining a healthy weight for children born prematurely. The findings suggest that obesity may compound the increased risk of hypertension and cardiovascular disease already present in this population by further disrupting the balance of the renin-angiotensin system. Parents and caregivers should focus on promoting healthy lifestyle habits, including a balanced diet and regular physical activity, to mitigate these risks.

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Everything You Need To Know

What is the Renin-Angiotensin System (RAS) and why is it relevant to premature birth and high blood pressure?

The Renin-Angiotensin System (RAS) is a critical regulator of blood pressure and overall cardiovascular function. It consists of two main pathways. One is the ACE/Ang II/Ang II type 1 receptor pathway, which increases blood pressure. The other is the ACE2/Ang-(1-7)/Mas receptor pathway, which counteracts the first by promoting vasodilation, sodium excretion, and inhibiting inflammation. Premature birth can affect the RAS, increasing the risk of chronic health conditions like hypertension. This is because events during the perinatal period can induce changes in the RAS, which may lead to a dysregulation of blood pressure control. Understanding these mechanisms is vital for preventive care in individuals born prematurely.

How does obesity specifically impact the RAS and blood pressure in adolescents born prematurely?

Recent research indicates that obesity is linked to higher levels of Ang II and lower levels of Ang-(1-7). This imbalance can potentially lead to increased blood pressure in adolescents born prematurely. The study quantified plasma and urinary Ang II and Ang-(1-7) levels, comparing overweight/obese adolescents to those with a healthy BMI. The findings showed that overweight/obesity was associated with a higher ratio of plasma Ang II to Ang-(1-7), increased Ang II levels, and decreased Ang-(1-7) levels. This imbalance exacerbates the risk of high blood pressure already present in individuals born prematurely.

What practical steps can parents and caregivers take to mitigate the risks of high blood pressure in preemies?

Parents and caregivers should focus on promoting healthy lifestyle habits to mitigate the risks of high blood pressure. Maintaining a healthy weight is paramount, as obesity can compound the risk of hypertension and cardiovascular disease. This includes promoting a balanced diet and encouraging regular physical activity. By focusing on these aspects, parents can help to manage and reduce the disruption in the renin-angiotensin system, supporting their child's cardiovascular health and well-being.

What were the key findings of the study regarding obesity, the RAS, and blood pressure in adolescents born prematurely?

The study revealed a significant association between overweight/obesity and blood pressure in adolescents born prematurely. The key findings included that overweight/obese adolescents had higher systolic blood pressure and a greater proportion with high blood pressure. After adjusting for race and antenatal corticosteroid exposure, it was found that overweight/obesity was linked to an elevated ratio of plasma Ang II to Ang-(1-7), higher Ang II levels, and lower Ang-(1-7) levels. A similar, though less statistically significant, trend was observed in urine samples. These results underscore the disruption in the RAS caused by obesity in this population.

How do race and antenatal corticosteroid exposure potentially influence the study's findings on obesity and blood pressure in preemies?

Race and antenatal corticosteroid exposure were considered as potential confounding factors in the study's analysis. The researchers accounted for these factors to ensure the observed relationship between obesity, the RAS, and blood pressure in adolescents born prematurely was accurate. It is known that both race and exposure to antenatal corticosteroids can influence the RAS. By adjusting for these factors, the study aimed to isolate the specific impact of obesity on the RAS and blood pressure, providing a more reliable understanding of the relationship between these factors. This adjustment helped to ensure the findings were not skewed by these additional variables.