title: Association between maternal education and blood pressure: mediation evidence through height components in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).
abstract: BACKGROUND
  Maternal education influences skeletal growth and offspring adult blood pressure (BP). Height components are negatively associated with BP in high-income countries.
  
  
  OBJECTIVE
  To evaluate the association between maternal education and offspring adult systolic and diastolic BP (SBP/DBP), assessing whether different height components might mediate such an association.
  
  
  METHODS
  Simple mediation modelling was used to evaluate the maternal education-offspring SBP/DBP association, estimating the contribution of offspring height components, in a cross-sectional sample of 13 571 Brazilians aged 34-75 from the ELSA-Brasil study.
  
  
  RESULTS
  After full adjustment for confounders, and compared to participants whose mothers received low education, those whose mothers received high education had, on average, 0.2 mm Hg lower SBP (95% CI = -0.274, -0.132), as result of the link between maternal education and offspring adult height which, in turn, influenced SBP. Thus, 18-26% of the maternal education-SBP association occurred indirectly, through height, trunk and leg length, alternatively.
  
  
  CONCLUSIONS
  Better maternal education might influence higher leg and trunk lengths in offspring, which, in turn, might contribute to prevent higher BP in adults. The negative height-BP association reported in high-income countries is also present in a middle-income country with more recent economic development.
authors.affiliation: a Center for Clinical and Epidemiologic Research , University of São Paulo , São Paulo , Brazil.|b Research and Study Centre on Culture and Society , National Scientific and Technical Research Council (CIECS-CONICET-UNC) , Córdoba , Argentina.|c Department of Biology , Autonomous University of Madrid , Madrid , Spain.
authors.forename: Santiago
authors.initials: S
authors.lastname: Rodríguez López
authors.affiliation: a Center for Clinical and Epidemiologic Research , University of São Paulo , São Paulo , Brazil.|d School of Medicine , University of São Paulo , São Paulo , Brazil.
authors.forename: Isabela M
authors.initials: IM
authors.lastname: Bensenor
authors.affiliation: e School of Nutrition , Federal University of Ouro Preto , Ouro Preto , Brazil.
authors.forename: Luana
authors.initials: L
authors.lastname: Giatti
authors.affiliation: f Center of Health Science , Federal University of Espírito Santo , Vitória , Brazil.
authors.forename: Maria Del Carmen
authors.initials: MDC
authors.lastname: Molina
authors.affiliation: a Center for Clinical and Epidemiologic Research , University of São Paulo , São Paulo , Brazil.|d School of Medicine , University of São Paulo , São Paulo , Brazil.
authors.forename: Paulo A
authors.initials: PA
authors.lastname: Lotufo
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D001827:Body Height; D001938:Brazil; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009035:Mothers
keywords: Maternal education; blood pressure; height components; mediation modelling; transitioning populations