Association between paternal cardiovascular status and offspring adolescent blood pressure trajectories

Abstract

Objective: To investigate the association between paternal circulatory health in middle age and offspring blood pressure across childhood and adolescence in order to examine the importance of inter-generational influences on blood pressure trajectories and the potential development of hypertension in later adult life. Design and method: We used data from 1,969 paternal-offspring pairs recruited as part of the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort. Paternal pressures and arterial stiffness (systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse wave velocity (PWV) and augmentation index (AI)) were measured at the Focus on Fathers clinic between 2011 to 2013. This was linked to 6 prior measures of offspring SBP and DBP taken at research clinics when the ALSPAC participants were approximately 7, 9, 10, 11, 15 and 17 years old. We used both multivariable linear regression and 2 level linear-spline models to model the associations between a one standard deviation increase (z-score) in paternal circulatory measures and offspring SBP and DBP at each time point as well as the intercept (BP at age 7) and rate of blood pressure change from linear slopes between ages 7–11, 11–15 and 15–17 from our multi-level model. Results: A positive association was found between paternal SBP and male offspring systolic and diastolic blood pressures in simple and adiposity adjusted analyses (SBP +1.48 mmHg; CI 0.82 - 2.14 mmHg, p < 0.0001 at age 7 for 1 z-score increase in paternal SBP). These associations remained similar throughout adolescence. No associations were seen with paternal PWV or AI and male offspring pressures. Far weaker or null associations were seen for female blood pressures (p-value for gender interaction=0.01 at 7 years). Conclusions: This study demonstrates sexual dimorphism for associations between paternal and offspring blood pressures which require replication from other studies. The associations were strongest in the pre-pubertal period and, if anything, weakened with adolescence suggesting other environmental factors may be more important in determining age-related increases in blood pressure. Future follow-up is required to test whether associations reappear in later life.