title: Hypertension in Pregnancy and Offspring Cardiovascular Risk in Young Adulthood: Prospective and Sibling Studies in the HUNT Study (Nord-Trøndelag Health Study) in Norway.
abstract: Women with hypertensive disorders in pregnancy are at increased lifetime risk for cardiovascular disease. We examined the offspring's cardiovascular risk profile in young adulthood and their siblings' cardiovascular risk profile. From the HUNT study (Nord-Trøndelag Health Study) in Norway, 15 778 participants (mean age: 29 years), including 210 sibling groups, were linked to information from the Medical Birth Registry of Norway. Blood pressure, anthropometry, serum lipids, and C-reactive protein were assessed. Seven hundred and six participants were born after exposure to maternal hypertension in pregnancy: 336 mothers had gestational hypertension, 343 had term preeclampsia, and 27 had preterm preeclampsia. Offspring whose mothers had hypertension in pregnancy had 2.7 (95% confidence interval, 1.8-3.5) mm Hg higher systolic blood pressure, 1.5 (0.9-2.1) mm Hg higher diastolic blood pressure, 0.66 (0.31-1.01) kg/m2higher body mass index, and 1.49 (0.65-2.33) cm wider waist circumference, compared with offspring of normotensive pregnancies. Similar differences were observed for gestational hypertension and term preeclampsia. Term preeclampsia was also associated with higher concentrations of non-high-density lipoprotein cholesterol (0.14 mmol/L, 0.03-0.25) and triglycerides (0.13 mmol/L, 0.06-0.21). Siblings born after a normotensive pregnancy had nearly identical risk factor levels as siblings born after maternal hypertension. Offspring born after maternal hypertension in pregnancy have a more adverse cardiovascular risk profile in young adulthood than offspring of normotensive pregnancies. Their siblings, born after a normotensive pregnancy, have a similar risk profile, suggesting that shared genes or lifestyle may account for the association, rather than an intrauterine effect. All children of mothers who have experienced hypertension in pregnancy may be at increased lifetime risk of cardiovascular disease.
authors.affiliation: From the Department of Public Health and General Practice, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, Trondheim (I.V.A., L.J.V., J.H.B., J.R.-E., P.R.R., B.O.Å.); MRC Integrative Epidemiology Unit at the University of Bristol and School of Social and Community Medicine, University of Bristol, United Kingdom (A.F.); Channing Division of Network Medicine, Department of Medicine, Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Boston, MA (J.R.-E.); Harvard Medical School, Boston, MA (J.R.-E.); Department of Epidemiology, the Harvard T.H. Chan School of Public Health, Boston, MA (L.J.V., J.R.-E.); and Department of Endocrinology, St. Olavs Hospital, Trondheim University Hospital, Norway (B.O.Å.). ingvild.vatten@gmail.com.
authors.forename: Ingvild V
authors.initials: IV
authors.lastname: Alsnes
authors.affiliation: From the Department of Public Health and General Practice, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, Trondheim (I.V.A., L.J.V., J.H.B., J.R.-E., P.R.R., B.O.Å.); MRC Integrative Epidemiology Unit at the University of Bristol and School of Social and Community Medicine, University of Bristol, United Kingdom (A.F.); Channing Division of Network Medicine, Department of Medicine, Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Boston, MA (J.R.-E.); Harvard Medical School, Boston, MA (J.R.-E.); Department of Epidemiology, the Harvard T.H. Chan School of Public Health, Boston, MA (L.J.V., J.R.-E.); and Department of Endocrinology, St. Olavs Hospital, Trondheim University Hospital, Norway (B.O.Å.).
authors.forename: Lars J
authors.initials: LJ
authors.lastname: Vatten
authors.affiliation: From the Department of Public Health and General Practice, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, Trondheim (I.V.A., L.J.V., J.H.B., J.R.-E., P.R.R., B.O.Å.); MRC Integrative Epidemiology Unit at the University of Bristol and School of Social and Community Medicine, University of Bristol, United Kingdom (A.F.); Channing Division of Network Medicine, Department of Medicine, Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Boston, MA (J.R.-E.); Harvard Medical School, Boston, MA (J.R.-E.); Department of Epidemiology, the Harvard T.H. Chan School of Public Health, Boston, MA (L.J.V., J.R.-E.); and Department of Endocrinology, St. Olavs Hospital, Trondheim University Hospital, Norway (B.O.Å.).
authors.forename: Abigail
authors.initials: A
authors.lastname: Fraser
authors.affiliation: From the Department of Public Health and General Practice, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, Trondheim (I.V.A., L.J.V., J.H.B., J.R.-E., P.R.R., B.O.Å.); MRC Integrative Epidemiology Unit at the University of Bristol and School of Social and Community Medicine, University of Bristol, United Kingdom (A.F.); Channing Division of Network Medicine, Department of Medicine, Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Boston, MA (J.R.-E.); Harvard Medical School, Boston, MA (J.R.-E.); Department of Epidemiology, the Harvard T.H. Chan School of Public Health, Boston, MA (L.J.V., J.R.-E.); and Department of Endocrinology, St. Olavs Hospital, Trondheim University Hospital, Norway (B.O.Å.).
authors.forename: Johan Håkon
authors.initials: JH
authors.lastname: Bjørngaard
authors.affiliation: From the Department of Public Health and General Practice, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, Trondheim (I.V.A., L.J.V., J.H.B., J.R.-E., P.R.R., B.O.Å.); MRC Integrative Epidemiology Unit at the University of Bristol and School of Social and Community Medicine, University of Bristol, United Kingdom (A.F.); Channing Division of Network Medicine, Department of Medicine, Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Boston, MA (J.R.-E.); Harvard Medical School, Boston, MA (J.R.-E.); Department of Epidemiology, the Harvard T.H. Chan School of Public Health, Boston, MA (L.J.V., J.R.-E.); and Department of Endocrinology, St. Olavs Hospital, Trondheim University Hospital, Norway (B.O.Å.).
authors.forename: Janet
authors.initials: J
authors.lastname: Rich-Edwards
authors.affiliation: From the Department of Public Health and General Practice, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, Trondheim (I.V.A., L.J.V., J.H.B., J.R.-E., P.R.R., B.O.Å.); MRC Integrative Epidemiology Unit at the University of Bristol and School of Social and Community Medicine, University of Bristol, United Kingdom (A.F.); Channing Division of Network Medicine, Department of Medicine, Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Boston, MA (J.R.-E.); Harvard Medical School, Boston, MA (J.R.-E.); Department of Epidemiology, the Harvard T.H. Chan School of Public Health, Boston, MA (L.J.V., J.R.-E.); and Department of Endocrinology, St. Olavs Hospital, Trondheim University Hospital, Norway (B.O.Å.).
authors.forename: Pål R
authors.initials: PR
authors.lastname: Romundstad
authors.affiliation: From the Department of Public Health and General Practice, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, Trondheim (I.V.A., L.J.V., J.H.B., J.R.-E., P.R.R., B.O.Å.); MRC Integrative Epidemiology Unit at the University of Bristol and School of Social and Community Medicine, University of Bristol, United Kingdom (A.F.); Channing Division of Network Medicine, Department of Medicine, Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Boston, MA (J.R.-E.); Harvard Medical School, Boston, MA (J.R.-E.); Department of Epidemiology, the Harvard T.H. Chan School of Public Health, Boston, MA (L.J.V., J.R.-E.); and Department of Endocrinology, St. Olavs Hospital, Trondheim University Hospital, Norway (B.O.Å.).
authors.forename: Bjørn O
authors.initials: BO
authors.lastname: Åsvold
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology* / Q000503:physiopathology; D015994:Incidence; D007231:Infant, Newborn; D009664:Norway / Q000453:epidemiology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D035781:Siblings
keywords: adolescent; blood pressure; cardiovascular disease; mother; preeclampsia