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Background: Elevated homocysteine (Hcy) is a known cardiovascular risk factor. But its role in transgenerational cardiometabolic risk is unknown. We hypothesize that maternal elevated Hcy can act alone or in combination with maternal prepregnancy obesity to increase child systolic blood pressure (SBP).
Methods: This study included 1279 mother-child dyads recruited at birth and followed prospectively up to age 9 years from 2003-2014 at the Boston Medical Center. Child SBP percentile was calculated according to U.S. reference data and elevated SBP was defined as SBP≥75th percentile.
Results: A U-shaped relationship between maternal Hcy and child SBP was observed: the risk for child elevated SBP was higher among those in the lowest quartile (Q1, odds ratio (ORs): 1.28; 95% confidence interval (CI):0.95, 1.73) and highest quartile (Q4, ORs: 1.35; 95%CI: 1.00-1.82) as compared with those in Q2-Q3. The highest risk of child elevated SBP was found among children born to obese mothers with Hcy in Q4 (ORs: 2.19; 95%CI: 1.33, 3.60) compared to children of non-obese mothers with Hcy in Q2-Q3. This association was independent from maternal folate and vitamin B12 and not mediated by gestational age or size at birth.
Conclusions: In this prospective birth cohort, there was a U- shaped association between maternal Hcy levels and child elevated SBP. Maternal high Hcy (Q4) and prepregnancy obesity jointly increased the risk of child elevated SBP by more than two folds.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Toward Precision Medicine in the Treatment of Elevated Blood Pressure
Abstract Category: 33. Prevention: Hypertension
Presentation Number: 1186-038
- 2017 American College of Cardiology Foundation