Parental History of Hypertension Is Associated With Narrower Retinal Arteriolar Caliber in Young Girls

Abstract

Abstract-We aimed to assess the associations between parental history of hypertension and indicators of cardiovascular risk (retinal vessel diameter, presence of obesity, and elevated blood pressure) in prepubertal children. There were 1739 (77.7% of those eligible) 6-year-old students (863 girls and 876 boys) who were examined from a random cluster sample of 34 Sydney schools. Parents completed questionnaires about their medical conditions, including whether they have/had hypertension. Retinal images were taken with a digital fundus camera, and retinal vessel caliber was quantified using computer software. Anthropometric (height, weight, percentage of body fat, and body mass index) and blood pressure measures were collected. There were 160 children (9.2%) with a positive parental history of hypertension (either biological mother and/or father Although it is clear that parental history has an overall impact on the hypertension risk profile of offspring, it is not known whether the effects of parental history are related to small vessel disease mechanisms. The retinal microvasculature is a microvascular bed that can be observed directly and noninvasively and, therefore, is a surrogate for the systemic microvasculature. 5,6 Consistent evidence is mounting that small vessel disease plays an important role in the development of hypertension and cardiovascular disease (CVD). 5,7,8 Studies in both adult and child populations show that narrower retinal arteriolar caliber and wider venular caliber are associated with CVD risk factors, including obesity and elevated BP. 6,9 -11 Moreover, retinal microvascular changes in adults appear to be structural markers of the subclinical stage of CVD that signals future risk of hypertension and vascular events. 5,7,8 Investigating a possible relationship between parental history of hypertension and the retinal microvasculature in offspring could highlight previously unexplored pathways in future hypertension and CVD development during childhood. We aimed to address 2 key questions in this study of a community-based sample of 6-year old children. First, is parental hypertension associated with adverse microvascular changes indicated by narrower retinal arterioles and wider retinal venules? Second, is parental hypertension associated with an unhealthy cardiovascular risk profile, indicated by adiposity and elevated BP? Methods Study PopulationThe Sydney Childhood Eye Study is a population-based survey of eye conditions in school-aged children from year 1 and 6 who were living within the Sydney Metropolitan Area in Australia. It was

Determinants of Retinal Venular Diameter: The Beaver Dam Eye Study

“…52 A 2011 study reported that 6-year-old daughters but not sons of hypertensive parents were more likely to have narrower retinal arterioles than daughters of parents who did not have hypertension. 53 It is also possible that changes in some factors (e.g., a history of CVD) associated with wider CRVE may be balanced by factors associated with narrower CRVE (e.g., stopping smoking). The relationship of smaller CRVE with increasing age may partially be due to selective survival.…”

2016 European Society of Hypertension guidelines for the management of high blood pressure in children and adolescents

“…Family history of HTN or CV disease may identify children and adolescents with essential HTN, but history of hereditary diseases associated with secondary forms of HTN should also be relevant (1,37). Parental history of HTN has been associated with masked HTN, early TOD, changes in central and peripheral hemodynamics, and can guide further evaluation (79,(93)(94)(95). A complete clinical history assessment may include information summaraised in Table 4.2.1.…”

Influence of Maternal Angiogenic Factors During Pregnancy on Microvascular Structure in School-Age Children

“…These covariates were selected based on their associations with placental function or the outcomes of interest based on previous studies or a change in the effect estimate of >10%. 12,[16][17][18] Table S2 shows the associations of each covariate with the outcomes of interest. Next, these models were additionally adjusted for gestational age at birth, birth weight, and child's current body mass index and blood pressure to explore whether the observed associations were explained by birth or childhood characteristics.…”