The following is a summary of “High Amino Acid Intake in Early Life Is Associated With Systolic but Not Diastolic Arterial Hypertension at 5 Years of Age in Children Born Very Preterm,” published in the December 2023 issue of Cardiology by Rozé et al.

The trajectory of individuals born significantly premature is an escalating concern, prompting exploration into potential associations between early amino acid intake and subsequent high blood pressure (HBP) in preterm neonates. Conducted within the national, prospective birth cohort EPIPAGE-2 (Etude Epidémiologique sur Petits Ages Gestationnels), this study focused on infants born between 24 and 29 weeks of gestation, categorizing them into groups based on exposure to high amino acid intake (>3.5 g/kg per day at day 7). 

A propensity score-matched cohort design included 717 exposed and non-exposed infants alongside 455 control-term infants. Blood pressure assessments at 5 years revealed rates of systolic and diastolic HBP, with 18.0% and 13.3% in the exposed group, 8.5% and 9.0% in the non-exposed, and 10.2% and 5.4% in the term-born group, respectively. Notably, high early amino acid intake and elevated maximal serum creatinine (by 50 μmol/L) between day 3 and day 7 emerged as independent risk factors for systolic HBP (adjusted odds ratio [aOR], 1.60 [95% CI, 1.05–2.43] and aOR, 1.59 [95% CI, 1.12–2.26], respectively) but not for diastolic HBP (aOR, 0.84 [95% CI, 0.50–1.39] and aOR, 1.09 [95% CI, 0.71–1.67], respectively). Even after adjusting for the 5-year weight Z score, the association between high early amino acid intake and systolic HBP persisted (aOR, 1.50 [95% CI, 0.98–2.30]). These findings suggest a potential link between neonatal renal challenge induced by high amino acid intake and childhood systolic HBP, underscoring the importance of early-life factors in long-term cardiovascular health.

Source: ahajournals.org/doi/10.1161/JAHA.123.032804