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J Am Heart Assoc. 2018 Jan 6;7(1). pii: e006284. doi: 10.1161/JAHA.117.006284.

Cardiometabolic Health Among Adult Offspring of Hypertensive Pregnancies: The Cardiovascular Risk in Young Finns Study.

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Melbourne School of Population and Global Health University of Melbourne, Australia
School of Clinical and Applied Sciences, Leeds Beckett University, Leeds, United Kingdom.
Department of Optometry and Vision Sciences, The University of Melbourne, Australia.
Institute of Cardiovascular Science, University College London, London, United Kingdom.
Department of Clinical Physiology, Tampere University Hospital and the University of Tampere, Finland.
Singapore National Eye Center, Singapore & Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, National University of Singapore, Singapore.
National Heart and Lung Institute, Imperial College London, London, United Kingdom.
Department of Clinical Chemistry, Fimlab Laboratories and School of Medicine, University of Tampere, Finland.
Department of Pediatrics, University of Tampere and Tampere University Hospital, Tampere, Finland.
Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Finland.
Turku University Hospital, Turku, Finland.
Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland.



Cardiometabolic health among adult offspring of hypertensive disorders of pregnancy (HDP) is relatively unknown. We hypothesized that offspring of HDP would have abnormalities in the retinal microvasculature and cardiac structure by midadulthood.


The Cardiovascular Risk in Young Finns Study included randomly selected children from 5 Finnish university cities. The mean age of participants was 40 years (range 34-49 years) at the time of retinal photography and cardiac assessment. Offspring born ≥37 weeks of gestation and appropriate for gestational age (n=1006) were included. Offspring of HDP had higher systolic blood pressure (β=4.68, P<0.001), body mass index (β=1.25, P=0.009), and waist circumference (β=0.25, P=0.042), compared with offspring of normotensive pregnancies. However, no differences in fasting glucose, insulin, lipid profile, carotid intima media thickness, or brachial artery flow-mediated dilatation were shown. Retinal arteriolar diameters were narrower (β=-0.43, P=0.009) and longer (β=32.5, P=0.023) and the arteriolar length-to-diameter ratio was higher (β=2.32, P=0.006) among offspring of HDP, after adjustment for age and sex. Left atrial volume indexed to body surface area (β=1.34, P=0.040) was increased. Adjustment for the confounding effects of birth weight, body mass index, smoking and socioeconomic status, and the mediating effect of hypertension had little impact on the associations.


Abnormalities of the retinal microvasculature and cardiac structure are seen in offspring of HDP in midadulthood. These findings may need to be considered in future primary prevention strategies of cardiovascular disease among offspring of HDP.


cardiac; health outcomes; microvascular dysfunction

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