Cardiovascular biomarkers and vascular function during childhood in the offspring of mothers with hypertensive disorders of pregnancy: findings from the Avon Longitudinal Study of Parents and Children

• Published in: European heart journal 2012-02, Vol.33 (3), p.335-345
• Main Authors: Lawlor, Debbie Anne, Macdonald-Wallis, Corrie, Fraser, Abigail, Nelson, Scott M., Hingorani, Aroon, Davey Smith, George, Sattar, Naveed, Deanfield, John
• Format: Article
• Language: English
• Subjects: Adult; Ankle Brachial Index; Arterial hypertension. Arterial hypotension; Biological and medical sciences; Biomarkers - metabolism; Blood and lymphatic vessels; Blood Pressure - physiology; Cardiology. Vascular system; Child; Clinical Research; Endothelium, Vascular - physiology; Female; Humans; Hypertension, Pregnancy-Induced; Lipid Metabolism - physiology; Longitudinal Studies; Medical sciences; Pregnancy; Prospective Studies; Vascular Diseases - blood; Vascular Diseases - etiology; Vascular Diseases - physiopathology
• ISSN: 0195-668X; 1522-9645
• DOI: 10.1093/eurheartj/ehr300

Aims It is uncertain if the higher blood pressure (BP) observed in the offspring of hypertensive pregnancies is an isolated abnormality or one that is accompanied by impaired vascular function and alterations in lipid and inflammation markers that would be indicative of a more general cardiometabolic disturbance of the type observed in the mother during pre-eclampsia. Methods and results In a large UK cohort of maternal-offspring pairs (n = 3537-4654), assessed at age 9-12 years, we examined the associations of maternal gestational hypertension and pre-eclampsia with offspring BP, endothelial function assessed by brachial artery flow-mediated dilatation; arterial stiffness assessed by carotid to radial pulse wave velocity; brachial artery distensibility and BP (vascular outcomes); as well as markers of inflammation, lipids and apolipoproteins A1 and B. Offspring of women with pre-eclampsia or gestational hypertension had higher systolic blood pressure by 2.04 mmHg (95% CI: 1.33, 2.76) and 1.82 mmHg (95% CI: 0.03, 3.62), respectively, and higher diastolic blood pressure by 1.10 mmHg (95% CI: 0.47, 1.73) and 1.26 mmHg (95% CI: −0.32, 2.85), respectively, in analyses adjusted for maternal and offspring body mass index (BMI), offspring dietary sodium intake and other potential confounders. However, we found no associations of either hypertensive disorder of pregnancy with the other vascular outcomes or with inflammatory markers, lipids, and apolipoproteins. Conclusion Pre-eclampsia and gestational hypertension are associated with higher offspring BP in childhood in the absence of other vascular alterations or metabolic derangements. The findings support the existence of shared mother-offspring risk factors that are specific for higher BP, rather than the additional cardiometabolic abnormalities of hypertensive disorder of pregnancy having long-term consequences for offspring.