Author + information
- Received May 5, 2018
- Revision received June 15, 2018
- Accepted June 18, 2018
- Published online September 3, 2018.
- Théo A. Meister, MDa,∗,
- Stefano F. Rimoldi, MDa,∗,
- Rodrigo Soria, MDa,
- Robert von Arx, MDa,
- Franz H. Messerli, MDa,
- Claudio Sartori, MDb,
- Urs Scherrer, MDa,c,† and
- Emrush Rexhaj, MDa,∗,† (, )@unibern@InselSpitalBern
- aDepartment of Cardiology, University Hospital and Department for Biomedical Research, University of Bern, Bern, Switzerland
- bDepartment of Internal Medicine, University Hospital, Lausanne, Switzerland
- cFaculty of Sciences, Department of Biology, University of Tarapacá, Arica, Chile
- ↵∗Address for correspondence:
Dr. Emrush Rexhaj, Department of Cardiology and Biomedical Research, Inselspital, University Hospital Bern, Freiburgstrasse, CH-3010 Bern, Switzerland.
Background Assisted reproductive technologies (ART) have been shown to induce premature vascular aging in apparently healthy children. In mice, ART-induced premature vascular aging evolves into arterial hypertension. Given the young age of the human ART group, long-term sequelae of ART-induced alterations of the cardiovascular phenotype are unknown.
Objectives This study hypothesized that vascular alterations persist in adolescents and young adults conceived by ART and that arterial hypertension possibly represents the first detectable clinically relevant endpoint in this group.
Methods Five years after the initial assessment, the study investigators reassessed vascular function and performed 24-h ambulatory blood pressure (BP) monitoring (ABPM) in 54 young, apparently healthy participants conceived through ART and 43 age- and sex-matched controls.
Results Premature vascular aging persisted in ART-conceived subjects, as evidenced by a roughly 25% impairment of flow-mediated dilation of the brachial artery (p < 0.001) and increased pulse-wave velocity and carotid intima-media thickness. Most importantly, ABPM values (systolic BP, 119.8 ± 9.1 mm Hg vs. 115.7 ± 7.0 mm Hg, p = 0.03; diastolic BP, 71.4 ± 6.1 mm Hg vs. 69.1 ± 4.2 mm Hg, p = 0.02 ART vs. control) and BP variability were markedly higher in ART-conceived subjects than in control subjects. Eight of the 52 ART participants, but only 1 of the 43 control participants (p = 0.041 ART vs. controls) fulfilled ABPM criteria of arterial hypertension (>130/80 mm Hg and/or >95th percentile).
Conclusions ART-induced premature vascular aging persists in apparently healthy adolescents and young adults without any other detectable classical cardiovascular risk factors and progresses to arterial hypertension. (Vascular Dysfunction in Offspring of Assisted Reproduction Technologies; NCT00837642.)
- arterial hypertension
- assisted reproductive technologies
- flow-mediated dilation
- endothelial dysfunction
↵∗ Drs. Meister and Rimoldi contributed equally to this work and are joint first authors.
↵† Drs. Scherrer and Rexhaj contributed equally to this work and are joint senior authors.
This work was supported by the Swiss National Science Foundation, the Placide Nicod Foundation, the Swiss Society of Hypertension, the Swiss Society of Cardiology, and the Mach-Gaensslen Stiftung Schweiz. All authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received May 5, 2018.
- Revision received June 15, 2018.
- Accepted June 18, 2018.
- 2018 American College of Cardiology Foundation
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