title: Association of Parental Hypertension With Arterial Stiffness in Nonhypertensive Offspring: The Framingham Heart Study.
abstract: High arterial stiffness seems to be causally involved in the pathogenesis of hypertension. We tested the hypothesis that offspring of parents with hypertension may display higher arterial stiffness before clinically manifest hypertension, given that hypertension is a heritable condition. We compared arterial tonometry measures in a sample of 1564 nonhypertensive Framingham Heart Study third-generation cohort participants (mean age: 38 years; 55% women) whose parents were enrolled in the Framingham Offspring Study. A total of 468, 715, and 381 participants had 0 (referent), 1, and 2 parents with hypertension. Parental hypertension was associated with greater offspring mean arterial pressure (multivariable-adjusted estimate=2.9 mm Hg; 95% confidence interval, 1.9-3.9, and 4.2 mm Hg; 95% confidence interval, 2.9-5.5, for 1 and 2 parents with hypertension, respectively; P<0.001 for both) and with greater forward pressure wave amplitude (1.6 mm Hg; 95% confidence interval, 0.6-2.7, and 1.9 mm Hg; 95% confidence interval, 0.6-3.2, for 1 and 2 parents with hypertension, respectively; P=0.003 for both). Carotid-femoral pulse wave velocity and augmentation index displayed similar dose-dependent relations with parental hypertension in sex-, age-, and height-adjusted models, but associations were attenuated on further adjustment. Offspring with at least 1 parent in the upper quartile of augmentation index and carotid-femoral pulse wave velocity had significantly higher values themselves (P≤0.02). In conclusion, in this community-based sample of young, nonhypertensive adults, we observed greater arterial stiffness in offspring of parents with hypertension. These observations are consistent with higher vascular stiffness at an early stage in the pathogenesis of hypertension.
authors.affiliation: From Boston University's and the National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA (C.A., M.G.L., D.L., E.J.B., R.S.V.); Section of Cardiology, Department of Internal Medicine, Glostrup Hospital, Denmark (C.A.); Cardiology Clinic of San Antonio, TX (R.Q.); Department of Epidemiology (D.E., E.J.B., R.S.V.) and Department of Biostatistics (M.G.L.), Boston University School of Public Health, MA; Department of Mathematics and Statistics, Boston University, MA (M.G.L.); Whitaker Cardiovascular Institute (N.M.H., J.A.V., E.J.B., R.S.V.) and Section of Preventive Medicine and Epidemiology (E.J.B., R.S.V.), Boston University School of Medicine, MA; National Heart, Lung and Blood Institute, Bethesda, MD (D.L.); and Cardiovascular Engineering, Inc, Norwood, MA (G.F.M.). ca@heart.dk.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Andersson
authors.affiliation: From Boston University's and the National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA (C.A., M.G.L., D.L., E.J.B., R.S.V.); Section of Cardiology, Department of Internal Medicine, Glostrup Hospital, Denmark (C.A.); Cardiology Clinic of San Antonio, TX (R.Q.); Department of Epidemiology (D.E., E.J.B., R.S.V.) and Department of Biostatistics (M.G.L.), Boston University School of Public Health, MA; Department of Mathematics and Statistics, Boston University, MA (M.G.L.); Whitaker Cardiovascular Institute (N.M.H., J.A.V., E.J.B., R.S.V.) and Section of Preventive Medicine and Epidemiology (E.J.B., R.S.V.), Boston University School of Medicine, MA; National Heart, Lung and Blood Institute, Bethesda, MD (D.L.); and Cardiovascular Engineering, Inc, Norwood, MA (G.F.M.).
authors.forename: Rene
authors.initials: R
authors.lastname: Quiroz
authors.affiliation: From Boston University's and the National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA (C.A., M.G.L., D.L., E.J.B., R.S.V.); Section of Cardiology, Department of Internal Medicine, Glostrup Hospital, Denmark (C.A.); Cardiology Clinic of San Antonio, TX (R.Q.); Department of Epidemiology (D.E., E.J.B., R.S.V.) and Department of Biostatistics (M.G.L.), Boston University School of Public Health, MA; Department of Mathematics and Statistics, Boston University, MA (M.G.L.); Whitaker Cardiovascular Institute (N.M.H., J.A.V., E.J.B., R.S.V.) and Section of Preventive Medicine and Epidemiology (E.J.B., R.S.V.), Boston University School of Medicine, MA; National Heart, Lung and Blood Institute, Bethesda, MD (D.L.); and Cardiovascular Engineering, Inc, Norwood, MA (G.F.M.).
authors.forename: Danielle
authors.initials: D
authors.lastname: Enserro
authors.affiliation: From Boston University's and the National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA (C.A., M.G.L., D.L., E.J.B., R.S.V.); Section of Cardiology, Department of Internal Medicine, Glostrup Hospital, Denmark (C.A.); Cardiology Clinic of San Antonio, TX (R.Q.); Department of Epidemiology (D.E., E.J.B., R.S.V.) and Department of Biostatistics (M.G.L.), Boston University School of Public Health, MA; Department of Mathematics and Statistics, Boston University, MA (M.G.L.); Whitaker Cardiovascular Institute (N.M.H., J.A.V., E.J.B., R.S.V.) and Section of Preventive Medicine and Epidemiology (E.J.B., R.S.V.), Boston University School of Medicine, MA; National Heart, Lung and Blood Institute, Bethesda, MD (D.L.); and Cardiovascular Engineering, Inc, Norwood, MA (G.F.M.).
authors.forename: Martin G
authors.initials: MG
authors.lastname: Larson
authors.affiliation: From Boston University's and the National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA (C.A., M.G.L., D.L., E.J.B., R.S.V.); Section of Cardiology, Department of Internal Medicine, Glostrup Hospital, Denmark (C.A.); Cardiology Clinic of San Antonio, TX (R.Q.); Department of Epidemiology (D.E., E.J.B., R.S.V.) and Department of Biostatistics (M.G.L.), Boston University School of Public Health, MA; Department of Mathematics and Statistics, Boston University, MA (M.G.L.); Whitaker Cardiovascular Institute (N.M.H., J.A.V., E.J.B., R.S.V.) and Section of Preventive Medicine and Epidemiology (E.J.B., R.S.V.), Boston University School of Medicine, MA; National Heart, Lung and Blood Institute, Bethesda, MD (D.L.); and Cardiovascular Engineering, Inc, Norwood, MA (G.F.M.).
authors.forename: Naomi M
authors.initials: NM
authors.lastname: Hamburg
authors.affiliation: From Boston University's and the National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA (C.A., M.G.L., D.L., E.J.B., R.S.V.); Section of Cardiology, Department of Internal Medicine, Glostrup Hospital, Denmark (C.A.); Cardiology Clinic of San Antonio, TX (R.Q.); Department of Epidemiology (D.E., E.J.B., R.S.V.) and Department of Biostatistics (M.G.L.), Boston University School of Public Health, MA; Department of Mathematics and Statistics, Boston University, MA (M.G.L.); Whitaker Cardiovascular Institute (N.M.H., J.A.V., E.J.B., R.S.V.) and Section of Preventive Medicine and Epidemiology (E.J.B., R.S.V.), Boston University School of Medicine, MA; National Heart, Lung and Blood Institute, Bethesda, MD (D.L.); and Cardiovascular Engineering, Inc, Norwood, MA (G.F.M.).
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Vita
authors.affiliation: From Boston University's and the National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA (C.A., M.G.L., D.L., E.J.B., R.S.V.); Section of Cardiology, Department of Internal Medicine, Glostrup Hospital, Denmark (C.A.); Cardiology Clinic of San Antonio, TX (R.Q.); Department of Epidemiology (D.E., E.J.B., R.S.V.) and Department of Biostatistics (M.G.L.), Boston University School of Public Health, MA; Department of Mathematics and Statistics, Boston University, MA (M.G.L.); Whitaker Cardiovascular Institute (N.M.H., J.A.V., E.J.B., R.S.V.) and Section of Preventive Medicine and Epidemiology (E.J.B., R.S.V.), Boston University School of Medicine, MA; National Heart, Lung and Blood Institute, Bethesda, MD (D.L.); and Cardiovascular Engineering, Inc, Norwood, MA (G.F.M.).
authors.forename: Daniel
authors.initials: D
authors.lastname: Levy
authors.affiliation: From Boston University's and the National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA (C.A., M.G.L., D.L., E.J.B., R.S.V.); Section of Cardiology, Department of Internal Medicine, Glostrup Hospital, Denmark (C.A.); Cardiology Clinic of San Antonio, TX (R.Q.); Department of Epidemiology (D.E., E.J.B., R.S.V.) and Department of Biostatistics (M.G.L.), Boston University School of Public Health, MA; Department of Mathematics and Statistics, Boston University, MA (M.G.L.); Whitaker Cardiovascular Institute (N.M.H., J.A.V., E.J.B., R.S.V.) and Section of Preventive Medicine and Epidemiology (E.J.B., R.S.V.), Boston University School of Medicine, MA; National Heart, Lung and Blood Institute, Bethesda, MD (D.L.); and Cardiovascular Engineering, Inc, Norwood, MA (G.F.M.).
authors.forename: Emelia J
authors.initials: EJ
authors.lastname: Benjamin
authors.affiliation: From Boston University's and the National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA (C.A., M.G.L., D.L., E.J.B., R.S.V.); Section of Cardiology, Department of Internal Medicine, Glostrup Hospital, Denmark (C.A.); Cardiology Clinic of San Antonio, TX (R.Q.); Department of Epidemiology (D.E., E.J.B., R.S.V.) and Department of Biostatistics (M.G.L.), Boston University School of Public Health, MA; Department of Mathematics and Statistics, Boston University, MA (M.G.L.); Whitaker Cardiovascular Institute (N.M.H., J.A.V., E.J.B., R.S.V.) and Section of Preventive Medicine and Epidemiology (E.J.B., R.S.V.), Boston University School of Medicine, MA; National Heart, Lung and Blood Institute, Bethesda, MD (D.L.); and Cardiovascular Engineering, Inc, Norwood, MA (G.F.M.).
authors.forename: Gary F
authors.initials: GF
authors.lastname: Mitchell
authors.affiliation: From Boston University's and the National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA (C.A., M.G.L., D.L., E.J.B., R.S.V.); Section of Cardiology, Department of Internal Medicine, Glostrup Hospital, Denmark (C.A.); Cardiology Clinic of San Antonio, TX (R.Q.); Department of Epidemiology (D.E., E.J.B., R.S.V.) and Department of Biostatistics (M.G.L.), Boston University School of Public Health, MA; Department of Mathematics and Statistics, Boston University, MA (M.G.L.); Whitaker Cardiovascular Institute (N.M.H., J.A.V., E.J.B., R.S.V.) and Section of Preventive Medicine and Epidemiology (E.J.B., R.S.V.), Boston University School of Medicine, MA; National Heart, Lung and Blood Institute, Bethesda, MD (D.L.); and Cardiovascular Engineering, Inc, Norwood, MA (G.F.M.).
authors.forename: Ramachandran S
authors.initials: RS
authors.lastname: Vasan
mesh_terms: D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination; D002318:Cardiovascular Diseases / Q000517:prevention & control; D016241:Child of Impaired Parents; D015331:Cohort Studies; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D006973:Hypertension / Q000235:genetics* / Q000503:physiopathology; D015994:Incidence; D008297:Male; D008365:Manometry / Q000379:methods; D008875:Middle Aged; D063177:Pulse Wave Analysis; D012016:Reference Values; D018570:Risk Assessment; D012494:Sampling Studies; D012737:Sex Factors; D014481:United States; D059289:Vascular Stiffness / Q000235:genetics* / Q000502:physiology
keywords: adult; atherosclerosis; blood pressure; hypertension; phenotype