Association of parental blood pressure with retinal microcirculatory abnormalities indicative of endothelial dysfunction in children

Objective: Microcirculatory abnormalities precede the onset of hypertension and may explain its familial nature. We examined the relationship between parental blood pressure (BP) and offspring retinal microvasculature in Pakistani trios [father, mother, and child (aged 9–14 years)]. Methods: This is a substudy of a population-based trial of BP reduction. Data were available on 358 normotensive, and 410 offspring of at least one hypertensive parent. Retinal vessel characteristics were measured from digital images. Multivariable linear regression models were built to assess the associations between maternal and paternal BP and offspring retinal microvasculature. Results: Optimality deviation was greatest in offspring of two hypertensive parents, compared with those with one or no hypertensive parent (P = 0.030 for trend). Paternal SBP and DBP were each significantly associated with optimality deviation in offspring (P = 0.023 and P = 0.006, respectively). This relationship persisted after accounting for offspring cardiovascular risk factors [increase in optimality deviation (95% confidence interval, CI) 0.0053 (0.0001–0.0106, P = 0.047) and 0.0109 (0.0025–0.0193, P = 0.011), for each 10 mmHg increase in paternal SBP and DBP, respectively]. Maternal DBP was inversely associated with offspring arteriovenous ratio −0.0102 (−0.0198 to −0.0007, P = 0.035). Conclusion: Microvascular endothelial dysfunction in children is associated with increasing levels of parental hypertension. The association with paternal BP is independent of other cardiovascular risk factors, including the child's BP. Higher maternal DBP is associated with evidence of arteriolar narrowing in offspring. These early microcirculatory changes may help explain familial predisposition to hypertension in people of Pakistani origin at an early age. Video Abstract: http://links.lww.com/HJH/A326

[1]  D. Grobbee,et al.  Parental blood pressure is related to vascular properties of their 5-year-old offspring. , 2012, American journal of hypertension.

[2]  Erdahl T. Teber,et al.  Parental History of Hypertension Is Associated With Narrower Retinal Arteriolar Caliber in Young Girls , 2011, Hypertension.

[3]  Alice V. Stanton,et al.  A novel measure to characterise optimality of diameter relationships at retinal vascular bifurcations , 2010, Artery research.

[4]  M. Rodríguez-Moran,et al.  Family history of hypertension and cardiovascular risk factors in prepubertal children. , 2010, American journal of hypertension.

[5]  P. Shah.  Paternal factors and low birthweight, preterm, and small for gestational age births: a systematic review. , 2010, American journal of obstetrics and gynecology.

[6]  D. Dunger,et al.  Maternal but Not Paternal Association of Ambulatory Blood Pressure With Albumin Excretion in Young Offspring With Type 1 Diabetes , 2009, Diabetes Care.

[7]  E. Ferrannini,et al.  Family history of hypertension, anthropometric parameters and markers of early atherosclerosis in young healthy individuals , 2009, Journal of Human Hypertension.

[8]  N. Özdemir,et al.  Ambulatory blood pressure monitoring in healthy children with parental hypertension , 2009, Pediatric Nephrology.

[9]  D. Levy,et al.  Association of Parental Hypertension With Concentrations of Select Biomarkers in Nonhypertensive Offspring , 2008, Hypertension.

[10]  P. Mitchell,et al.  Evidence of Arteriolar Narrowing in Low-Birth-Weight Children , 2008, Circulation.

[11]  A. Hughes,et al.  Ethnic differences in retinal microvascular structure , 2008, Diabetologia.

[12]  Youfa Wang,et al.  Tracking of Blood Pressure From Childhood to Adulthood: A Systematic Review and Meta–Regression Analysis , 2008, Circulation.

[13]  T. Erlinger,et al.  Blood pressure change and risk of hypertension associated with parental hypertension: the Johns Hopkins Precursors Study. , 2008, Archives of internal medicine.

[14]  S. Blair,et al.  Physical Activity and Blood Pressure in Childhood: Findings From a Population-Based Study , 2008, Hypertension.

[15]  Nish Chaturvedi,et al.  Impact of Size at Birth on the Microvasculature: The Avon Longitudinal Study of Parents and Children , 2007, Pediatrics.

[16]  N. Chaturvedi,et al.  Rise in childhood obesity with persistently high rates of undernutrition among urban school-aged Indo-Asian children , 2007, Archives of Disease in Childhood.

[17]  T. Wong,et al.  Retinal Vascular Changes in Pre-Diabetes and Prehypertension , 2007, Diabetes Care.

[18]  J. J. Wang,et al.  Body mass index and its effects on retinal vessel diameter in 6-year-old children , 2007, International Journal of Obesity.

[19]  T. Wong,et al.  Retinal vascular manifestations of metabolic disorders , 2006, Trends in Endocrinology & Metabolism.

[20]  R. Klein,et al.  Abnormalities of Retinal Microvascular Structure and Risk of Mortality From Ischemic Heart Disease and Stroke , 2006, Hypertension.

[21]  I. Goldstein,et al.  Ambulatory blood pressure and family history of hypertension in healthy men and women. , 2006, American journal of hypertension.

[22]  Ronald Klein,et al.  Genome-Wide Linkage Study of Retinal Vessel Diameters in the Beaver Dam Eye Study , 2006, Hypertension.

[23]  C. Schmid,et al.  Children in South Asia Have Higher Body Mass–Adjusted Blood Pressure Levels Than White Children in the United States: A Comparative Study , 2005, Circulation.

[24]  D. Kaye,et al.  Impaired l-Arginine Transport and Endothelial Function in Hypertensive and Genetically Predisposed Normotensive Subjects , 2004, Circulation.

[25]  Tien Yin Wong,et al.  Retinal Arteriolar Diameter and Risk for Hypertension , 2004, Annals of Internal Medicine.

[26]  Nish Chaturvedi,et al.  Ethnic differences and determinants of proteinuria among South Asian subgroups in Pakistan. , 2003, Kidney international.

[27]  S. Harrap,et al.  Antihypertensive Treatments Obscure Familial Contributions to Blood Pressure Variation , 2003, Hypertension.

[28]  J. Staessen,et al.  Maternal and Paternal Influences on Left Ventricular Mass of Offspring , 2003, Hypertension.

[29]  E. Boerwinkle,et al.  Interacting effects of gender and genotype on blood pressure response to hydrochlorothiazide. , 2002, Kidney international.

[30]  N. Chapman,et al.  Peripheral vascular disease is associated with abnormal arteriolar diameter relationships at bifurcations in the human retina. , 2002, Clinical science.

[31]  L. Jacobson,et al.  Low Gestational Age Associated with Abnormal Retinal Vascularization and Increased Blood Pressure in Adult Women , 2002, Pediatric Research.

[32]  R. Klein,et al.  Retinal arteriolar narrowing and risk of coronary heart disease in men and women. The Atherosclerosis Risk in Communities Study. , 2002, JAMA.

[33]  J. Buring,et al.  Maternal and Paternal History of Myocardial Infarction and Risk of Cardiovascular Disease in Men and Women , 2001, Circulation.

[34]  A. Bharath,et al.  Computer algorithms for the automated measurement of retinal arteriolar diameters , 2001, The British journal of ophthalmology.

[35]  J. Panza,et al.  Transient Hypertension Directly Impairs Endothelium-Dependent Vasodilation of the Human Microvasculature , 2000, Hypertension.

[36]  A. Hughes,et al.  Acute effects of oxygen and carbon dioxide on retinal vascular network geometry in hypertensive and normotensive subjects. , 2000, Clinical science.

[37]  M. Marre.  Genetics and the prediction of complications in type 1 diabetes. , 1999, Diabetes care.

[38]  D. P. Davies,et al.  Endothelial function is impaired in fit young adults of low birth weight. , 1998, Cardiovascular research.

[39]  V. Burke,et al.  Family history as a predictor of blood pressure in a longitudinal study of Australian children , 1998, Journal of hypertension.

[40]  A. Hofman,et al.  Cardiovascular response to physical stress in offspring of hypertensive parents: Dutch Hypertension and Offspring Study. , 1996, Journal of human hypertension.

[41]  R. Zulli,et al.  Cardiovascular characteristics in normotensive subjects with or without family history of hypertension. , 1996, Clinical and experimental hypertension.

[42]  L. Ghiadoni,et al.  Defective L-arginine-nitric oxide pathway in offspring of essential hypertensive patients. , 1996, Circulation.

[43]  C. Sing,et al.  Probability of having hypertension: effects of sex, history of hypertension in parents, and other risk factors. , 1996, Journal of clinical epidemiology.

[44]  S. Corrao,et al.  Heredity and obesity-associated hypertension: impact of hormonal characteristics and left ventricular mass , 1995, Journal of hypertension.

[45]  A. Stanton,et al.  A method of quantifying retinal microvascular alterations associated with blood pressure and age , 1995, Journal of hypertension.

[46]  S. Daniels,et al.  Determinants of retinal vascular abnormalities in children and adolescents with essential hypertension. , 1993, Journal of human hypertension.

[47]  A. Salvetti,et al.  Vasodilation to acetylcholine in primary and secondary forms of human hypertension. , 1993, Hypertension.

[48]  A. Quyyumi,et al.  Role of Endothelium‐Derived Nitric Oxide in the Abnormal Endothelium‐Dependent Vascular Relaxation of Patients With Essential Hypertension , 1993, Circulation.

[49]  E. Rimm,et al.  A prospective study of parental history of myocardial infarction and coronary artery disease in men. , 1991, The American journal of cardiology.

[50]  A. Quyyumi,et al.  Abnormal endothelium-dependent vascular relaxation in patients with essential hypertension. , 1990, The New England journal of medicine.

[51]  D. Edwards,et al.  EDRF coordinates the behaviour of vascular resistance vessels , 1987, Nature.

[52]  A. Fanaroff,et al.  Hypertensive retinopathy in the newborn infant. , 1983, The Journal of pediatrics.

[53]  Guohui Li,et al.  : Transient , 2023 .

[54]  Anke Schmid,et al.  Statistics Applied To Clinical Trials , 2016 .

[55]  W. Elliott.  Community-Based Interventions to Promote Blood Pressure Control in a Developing Country: A Cluster Randomized Trial , 2010 .

[56]  E. Benjamin,et al.  Bmc Medical Genetics Genome-wide Association of Echocardiographic Dimensions, Brachial Artery Endothelial Function and Treadmill Exercise Responses in the Framingham Heart Study , 2022 .