Physical, Behavioural and Genetic Predictors of Adult Hypertension: The Findings of the Kaunas Cardiovascular Risk Cohort Study

Abstract

BackgroundThe roots of adult hypertension go back to childhood. This study aimed to examine the independent effects of physical, behavioural and genetic factors identified in childhood and mid-adulthood for prediction of adult hypertension.MethodsThe study subjects were participants of the Kaunas Cardiovascular Risk Cohort study started in 1977 (n = 1082, age 12–13 years). In 2012, a total of 507 individuals (63.9% of eligible sample) participated in the 35-year follow-up survey. Health examination involved measurements of blood pressure (BP), anthropometric parameters, and interview about health behaviours. Subjects were genotyped for AGT (M235T), ACE (I/D, rs4340), ADM (rs7129220), and CACNB2 (rs12258967) genes polymorphisms. A genetic risk score was calculated as the sum of the number of risk alleles at each of four single nucleotide polymorphisms.Results AGT TT genotype male carriers had the highest mean values of systolic BP in childhood. In females, ADM genotype AA was associated with the highest values of systolic and diastolic BP, while CACNB2 genotype CC carriers had the highest values of diastolic BP in childhood. Systolic and diastolic BP in childhood, gain in BMI from childhood to adulthood, and risky alcohol consumption predicted hypertension in middle-aged men. In women, genetic risk score together with diastolic BP in childhood and gain in BMI were significant predictors of adult hypertension. The comparison of four nested logistic regression models showed that the prediction of hypertension improved significantly after the addition of BMI gain. Genetic risk score had a relatively weak effect on the improvement of the model performance in women.ConclusionsBP in childhood and the gain in BMI from childhood to adulthood were significant predictors of adult hypertension in both genders. Genetic risk score in women and risky alcohol consumption in men were independently related with the risk of adult hypertension.

Associations between risk factors in childhood (12–13 years) and adulthood (48–49 years) and subclinical atherosclerosis: the Kaunas Cardiovascular Risk Cohort Study

“…Those findings do not mean that early CVD prevention and intervention measures during childhood might be irrelevant. Our previous studies confirmed that childhood BP was related with adult hypertension, also childhood BMI was associated with risk of adult obesity, metabolic syndrome, hyperglycaemia and diabetes [ 17 , 33 ]. A substantial part of individuals with elevated childhood BP and increased childhood BMI had high CVD risk profile in adulthood.…”

“…One of the reasons for this was a high rate of emigration from Lithuania over the last decades. Although no differences between participants and non-participants were found in existing baseline measurements [ 17 ], the bias due to differential loss to follow-up was possible.…”

“…This study used data from the Kaunas Cardiovascular Risk Cohort study, a prospective study with the baseline data collected in 1977 on a random sample of 1082 Kaunas schoolchildren aged 12–13 years [ 16 , 17 ]. Over the period of follow-up, 8.4 % (n = 91) individuals died, 9.5 % (n = 103) emigrated from Lithuania, 0.4 % (n = 4) were severely ill and the addresses of 8.3 % (n = 90) subjects were not available in the National Population Register.…”

Personalized Medicine Applied to Forensic Sciences: New Advances and Perspectives for a Tailored Forensic Approach

“…Gene polymorphisms predisposing to the development of hypertension have been described, the most important affecting the genes coding for angiotensinogen (AGT), angiotensin II receptor type 1 (AGTR1), angiotensin converting enzyme (ACE) and integrin beta 3 (ITGB3 -HPA-1) ( Table 3) [37,38].…”

Associations of renin-angiotensin system genetic polymorphisms and clinical course after aneurysmal subarachnoid hemorrhage

“…The AGT TT genotype is associated with hypertension in women and increased plasma AGT levels. 25,27 The CC genotype may result in decreased AGT levels and subsequently decreased local RAS activity. Re-duced vascular remodeling due to locally downregulated RAS may lead to thinning and weakening of the arterial wall and aneurysm rupture at a smaller size.…”