{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T13:05:41Z","timestamp":1792069541479,"version":"4.4.0"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Hypertension"],"published-print":{"date-parts":[[2014,9]]},"abstract":"<jats:p>\n            Malnutrition below 5 years remains a global health issue. Severe acute malnutrition (SAM) presents in childhood as oedematous (kwashiorkor) or nonoedematous (marasmic) forms, with unknown long-term cardiovascular consequences. We hypothesized that cardiovascular structure and function would be poorer in SAM survivors than unexposed controls. We studied 116 adult SAM survivors, 54 after marasmus, 62 kwashiorkor, and 45 age\/sex\/body mass index\u2013matched community controls who had standardized anthropometry, blood pressure, echocardiography, and arterial tonometry performed. Left ventricular indices and outflow tract diameter, carotid parameters, and pulse wave velocity were measured, with systemic vascular resistance calculated. All were expressed as SD scores. Mean (SD) age was 28.8\u00b17.8 years (55% men). Adjusting for age, sex, height, and weight, SAM survivors had mean (SE) reductions for left ventricular outflow tract diameter of 0.67 (0.16;\n            <jats:italic>P<\/jats:italic>\n            &lt;0.001), stroke volume 0.44 (0.17;\n            <jats:italic>P<\/jats:italic>\n            =0.009), cardiac output 0.5 (0.16;\n            <jats:italic>P<\/jats:italic>\n            =0.001), and pulse wave velocity 0.32 (0.15;\n            <jats:italic>P<\/jats:italic>\n            =0.03) compared with controls but higher diastolic blood pressures (by 4.3; 1.2\u20137.3 mm Hg;\n            <jats:italic>P<\/jats:italic>\n            =0.007). Systemic vascular resistance was higher in marasmus and kwashiorkor survivors (30.2 [1.2] and 30.8 [1.1], respectively) than controls 25.3 (0.8), overall difference 5.5 (95% confidence interval, 2.8\u20138.4 mm Hg min\/L;\n            <jats:italic>P<\/jats:italic>\n            &lt;0.0001). No evidence of large vessel or cardiac remodeling was found, except closer relationships between these indices in former marasmic survivors. Other parameters did not differ between SAM survivor groups. We conclude that adult SAM survivors had smaller outflow tracts and cardiac output when compared with controls, yet markedly elevated peripheral resistance. Malnutrition survivors are thus likely to develop excess hypertension in later life, especially when exposed to obesity.\n          <\/jats:p>","DOI":"10.1161\/hypertensionaha.114.03230","type":"journal-article","created":{"date-parts":[[2014,7,1]],"date-time":"2014-07-01T14:42:36Z","timestamp":1404225756000},"page":"664-671","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":52,"title":["Impaired Cardiovascular Structure and Function in Adult Survivors of Severe Acute Malnutrition"],"prefix":"10.1161","volume":"64","author":[{"given":"Ingrid A.","family":"Tennant","sequence":"first","affiliation":[{"name":"From the Tropical Medicine Research Institute (D.S.T., M.S.B.), Departments of Surgery, Radiology, Anaesthesia, and Intensive Care (I.A.T., A.T.B.), Medicine (Cardiology) (E.E.C., A.P.C.), and UWI Solutions for Developing Countries (T.E.F.), University of the West Indies, Mona, Kingston, Jamaica; Institute Biomedical Technology, Ghent University, Gent, Belgium (J.K., P.S.); MRC Lifecourse Epidemiology Unit (C.O.) and DOHAD Division (M.A.H.), University of Southampton, Southampton, United Kingdom;..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan T.","family":"Barnett","sequence":"additional","affiliation":[{"name":"From the Tropical Medicine Research Institute (D.S.T., M.S.B.), Departments of Surgery, Radiology, Anaesthesia, and Intensive Care (I.A.T., A.T.B.), Medicine (Cardiology) (E.E.C., A.P.C.), and UWI Solutions for Developing Countries (T.E.F.), University of the West Indies, Mona, Kingston, Jamaica; Institute Biomedical Technology, Ghent University, Gent, Belgium (J.K., P.S.); MRC Lifecourse Epidemiology Unit (C.O.) and DOHAD Division (M.A.H.), University of Southampton, Southampton, United Kingdom;..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debbie S.","family":"Thompson","sequence":"additional","affiliation":[{"name":"From the Tropical Medicine Research Institute (D.S.T., M.S.B.), Departments of Surgery, Radiology, Anaesthesia, and Intensive Care (I.A.T., A.T.B.), Medicine (Cardiology) (E.E.C., A.P.C.), and UWI Solutions for Developing Countries (T.E.F.), University of the West Indies, Mona, Kingston, Jamaica; Institute Biomedical Technology, Ghent University, Gent, Belgium (J.K., P.S.); MRC Lifecourse Epidemiology Unit (C.O.) and DOHAD Division (M.A.H.), University of Southampton, Southampton, United Kingdom;..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Kips","sequence":"additional","affiliation":[{"name":"From the Tropical Medicine Research Institute (D.S.T., M.S.B.), Departments of Surgery, Radiology, Anaesthesia, and Intensive Care (I.A.T., A.T.B.), Medicine (Cardiology) (E.E.C., A.P.C.), and UWI Solutions for Developing Countries (T.E.F.), University of the West Indies, Mona, Kingston, Jamaica; Institute Biomedical Technology, Ghent University, Gent, Belgium (J.K., P.S.); MRC Lifecourse Epidemiology Unit (C.O.) and DOHAD Division (M.A.H.), University of Southampton, Southampton, United Kingdom;..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael S.","family":"Boyne","sequence":"additional","affiliation":[{"name":"From the Tropical Medicine Research Institute (D.S.T., M.S.B.), Departments of Surgery, Radiology, Anaesthesia, and Intensive Care (I.A.T., A.T.B.), Medicine (Cardiology) (E.E.C., A.P.C.), and UWI Solutions for Developing Countries (T.E.F.), University of the West Indies, Mona, Kingston, Jamaica; Institute Biomedical Technology, Ghent University, Gent, Belgium (J.K., P.S.); MRC Lifecourse Epidemiology Unit (C.O.) and DOHAD Division (M.A.H.), University of Southampton, Southampton, United Kingdom;..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward E.","family":"Chung","sequence":"additional","affiliation":[{"name":"From the Tropical Medicine Research Institute (D.S.T., M.S.B.), Departments of Surgery, Radiology, Anaesthesia, and Intensive Care (I.A.T., A.T.B.), Medicine (Cardiology) (E.E.C., A.P.C.), and UWI Solutions for Developing Countries (T.E.F.), University of the West Indies, Mona, Kingston, Jamaica; Institute Biomedical Technology, Ghent University, Gent, Belgium (J.K., P.S.); MRC Lifecourse Epidemiology Unit (C.O.) and DOHAD Division (M.A.H.), University of Southampton, Southampton, United Kingdom;..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrene P.","family":"Chung","sequence":"additional","affiliation":[{"name":"From the Tropical Medicine Research Institute (D.S.T., M.S.B.), Departments of Surgery, Radiology, Anaesthesia, and Intensive Care (I.A.T., A.T.B.), Medicine (Cardiology) (E.E.C., A.P.C.), and UWI Solutions for Developing Countries (T.E.F.), University of the West Indies, Mona, Kingston, Jamaica; Institute Biomedical Technology, Ghent University, Gent, Belgium (J.K., P.S.); MRC Lifecourse Epidemiology Unit (C.O.) and DOHAD Division (M.A.H.), University of Southampton, Southampton, United Kingdom;..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clive","family":"Osmond","sequence":"additional","affiliation":[{"name":"From the Tropical Medicine Research Institute (D.S.T., M.S.B.), Departments of Surgery, Radiology, Anaesthesia, and Intensive Care (I.A.T., A.T.B.), Medicine (Cardiology) (E.E.C., A.P.C.), and UWI Solutions for Developing Countries (T.E.F.), University of the West Indies, Mona, Kingston, Jamaica; Institute Biomedical Technology, Ghent University, Gent, Belgium (J.K., P.S.); MRC Lifecourse Epidemiology Unit (C.O.) and DOHAD Division (M.A.H.), University of Southampton, Southampton, United Kingdom;..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark A.","family":"Hanson","sequence":"additional","affiliation":[{"name":"From the Tropical Medicine Research Institute (D.S.T., M.S.B.), Departments of Surgery, Radiology, Anaesthesia, and Intensive Care (I.A.T., A.T.B.), Medicine (Cardiology) (E.E.C., A.P.C.), and UWI Solutions for Developing Countries (T.E.F.), University of the West Indies, Mona, Kingston, Jamaica; Institute Biomedical Technology, Ghent University, Gent, Belgium (J.K., P.S.); MRC Lifecourse Epidemiology Unit (C.O.) and DOHAD Division (M.A.H.), University of Southampton, Southampton, United Kingdom;..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter D.","family":"Gluckman","sequence":"additional","affiliation":[{"name":"From the Tropical Medicine Research Institute (D.S.T., M.S.B.), Departments of Surgery, Radiology, Anaesthesia, and Intensive Care (I.A.T., A.T.B.), Medicine (Cardiology) (E.E.C., A.P.C.), and UWI Solutions for Developing Countries (T.E.F.), University of the West Indies, Mona, Kingston, Jamaica; Institute Biomedical Technology, Ghent University, Gent, Belgium (J.K., P.S.); MRC Lifecourse Epidemiology Unit (C.O.) and DOHAD Division (M.A.H.), University of Southampton, Southampton, United Kingdom;..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Segers","sequence":"additional","affiliation":[{"name":"From the Tropical Medicine Research Institute (D.S.T., M.S.B.), Departments of Surgery, Radiology, Anaesthesia, and Intensive Care (I.A.T., A.T.B.), Medicine (Cardiology) (E.E.C., A.P.C.), and UWI Solutions for Developing Countries (T.E.F.), University of the West Indies, Mona, Kingston, Jamaica; Institute Biomedical Technology, Ghent University, Gent, Belgium (J.K., P.S.); MRC Lifecourse Epidemiology Unit (C.O.) and DOHAD Division (M.A.H.), University of Southampton, Southampton, United Kingdom;..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Kennedy","family":"Cruickshank","sequence":"additional","affiliation":[{"name":"From the Tropical Medicine Research Institute (D.S.T., M.S.B.), Departments of Surgery, Radiology, Anaesthesia, and Intensive Care (I.A.T., A.T.B.), Medicine (Cardiology) (E.E.C., A.P.C.), and UWI Solutions for Developing Countries (T.E.F.), University of the West Indies, Mona, Kingston, Jamaica; Institute Biomedical Technology, Ghent University, Gent, Belgium (J.K., P.S.); MRC Lifecourse Epidemiology Unit (C.O.) and DOHAD Division (M.A.H.), University of Southampton, Southampton, United Kingdom;..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terrence E.","family":"Forrester","sequence":"additional","affiliation":[{"name":"From the Tropical Medicine Research Institute (D.S.T., M.S.B.), Departments of Surgery, Radiology, Anaesthesia, and Intensive Care (I.A.T., A.T.B.), Medicine (Cardiology) (E.E.C., A.P.C.), and UWI Solutions for Developing Countries (T.E.F.), University of the West Indies, Mona, Kingston, Jamaica; Institute Biomedical Technology, Ghent University, Gent, Belgium (J.K., P.S.); MRC Lifecourse Epidemiology Unit (C.O.) and DOHAD Division (M.A.H.), University of Southampton, Southampton, United Kingdom;..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61690-0"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1753-4887.2012.00543.x"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra0708473"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1038\/nature02725"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60234-8"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61692-4"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehr228"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.2337\/db11-1559"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.111.022038"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0035907"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/82.4.792"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/83.6.1283"},{"issue":"1","key":"e_1_3_3_14_2","first-page":"22","article-title":"Trends in admission and case fatality for acute malnutrition, Kingston 1982\u20131992.","volume":"45","author":"Cooper ES","year":"1996","unstructured":"Cooper ES, Smartt V. Trends in admission and case fatality for acute malnutrition, Kingston 1982\u20131992. West Indian Med J. 1996;45(1):22\u201324.","journal-title":"West Indian Med J"},{"key":"e_1_3_3_15_2","first-page":"302","article-title":"Classification of infantile malnutrition.","volume":"2","author":"Shattock FM","year":"1970","unstructured":"Shattock FM. Classification of infantile malnutrition. Lancet. 1970;2:302\u2013303.","journal-title":"Lancet"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehl254"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1042\/cs0780463"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000033824.02722.F7"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/hypertensionaha.106.085480"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/hypertensionaha.109.133009"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehq165"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/hypertensionaha.110.150250"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.25.4.651"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(96)00225-2"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pbiomolbio.2010.11.010"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.306.6875.422"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1019726108"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1681.2001.03554.x"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1161\/hypertensionaha.111.178194"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.111.00006"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1155\/2010\/543514"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1161\/hypertensionaha.109.129320"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.psyneuen.2008.12.005"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000161960.78745.33"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)10508-0"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.10.061"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.09.063"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.37.5.1236"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.3109\/07853890.2011.653398"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.hyp.0000250434.73119.7a"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1097\/00004872-200501000-00009"}],"container-title":["Hypertension"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/HYPERTENSIONAHA.114.03230","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T09:40:40Z","timestamp":1715593240000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/HYPERTENSIONAHA.114.03230"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,9]]},"references-count":40,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2014,9]]}},"alternative-id":["10.1161\/HYPERTENSIONAHA.114.03230"],"URL":"https:\/\/doi.org\/10.1161\/hypertensionaha.114.03230","relation":{},"ISSN":["0194-911X","1524-4563"],"issn-type":[{"value":"0194-911X","type":"print"},{"value":"1524-4563","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,9]]},"assertion":[{"value":"2014-01-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-05-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-06-30","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}