Abstract 077: In Utero Exposure To Metal Mixtures And Offspring Blood Pressure: An Analysis Of The Boston Birth Cohort Using Bayesian Kernel Machine Regression

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Mingyu Zhang ◽  
Tiange Liu ◽  
Guoying Wang ◽  
Jessie P Buckley ◽  
Eliseo Guallar ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Birth Cohort ◽  
In Utero ◽  
Linear Regression Models ◽  
Metal Mixtures ◽  
Kernel Machine ◽  
American Academy Of Pediatrics ◽  
Kernel Machine Regression ◽  
The Individual ◽  
Antioxidant Effects

Background: In utero exposure to metals lead (Pb), cadmium (Cd), and mercury (Hg) may be associated with higher childhood systolic blood pressure (SBP), while trace elements manganese (Mn) and selenium (Se) may have protective, antioxidant effects that modify metal-SBP associations. No study has examined how in utero co-exposure to these metals affect offspring SBP. Objectives: To examine the individual and joint effects of in utero exposure to Cd, Pb, Hg, Mn, and Se on offspring SBP. Methods: We used data from the Boston Birth Cohort (enrolled 2002-2013). We measured metals in maternal red blood cells collected 24-72 hours after delivery. We calculated child age-, sex-, and height-specific SBP percentile per 2017 American Academy of Pediatrics guidelines. We used linear regression models to estimate associations of each metal, and Bayesian kernel machine regression (BKMR) to examine metal co-exposures, with child SBP between 3 to 15 years of age. Results: Our analytic sample comprised 1194 mother-child pairs (61% Black, 20% Hispanic). Hg and Pb were not associated with child SBP. Se and Mn were inversely associated with child SBP: each log2(Se) and log2(Mn) increment was associated with a 6.23 (95% CI: 0.96-11.51) and a 2.62 (95% CI: 0.04-5.20) percentile lower child SBP, respectively. BKMR models showed similar results ( Panel A ). While Cd was not overall associated with child SBP, there was an antagonistic interaction between Cd and Mn (P-interaction = 0.036): the association of Mn and lower child SBP was stronger with higher levels of Cd ( Panel B ). Consistent with this finding, in utero exposure to cigarette smoke (a major source of Cd) modified the association of Mn and child SBP: among children born mothers who smoked cigarette in pregnancy, each log2(Mn) increment was associated with a 10.09 (95% CI: 2.15-18.03) percentile lower SBP ( Panel C ). Conclusion: Optimizing in utero Se levels, as well as Mn levels in pregnant women who had high Cd or smoked during pregnancy, may protect offspring from developing high BP during childhood.

scholarly journals Prenatal metal mixtures and child blood pressure in the Rhea mother-child cohort in Greece

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Caitlin G. Howe ◽  
Katerina Margetaki ◽  
Marina Vafeiadi ◽  
Theano Roumeliotaki ◽  
Marianna Karachaliou ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Prenatal Exposure ◽  
Metal Mixture ◽  
Metal Mixtures ◽  
Longitudinal Changes ◽  
Kernel Machine ◽  
Inflection Points ◽  
Kernel Machine Regression ◽  
Lead Magnesium ◽  
Early Effects

Abstract Background Child blood pressure (BP) is predictive of future cardiovascular risk. Prenatal exposure to metals has been associated with higher BP in childhood, but most studies have evaluated elements individually and measured BP at a single time point. We investigated impacts of prenatal metal mixture exposures on longitudinal changes in BP during childhood and elevated BP at 11 years of age. Methods The current study included 176 mother-child pairs from the Rhea Study in Heraklion, Greece and focused on eight elements (antimony, arsenic, cadmium, cobalt, lead, magnesium, molybdenum, selenium) measured in maternal urine samples collected during pregnancy (median gestational age at collection: 12 weeks). BP was measured at approximately 4, 6, and 11 years of age. Covariate-adjusted Bayesian Varying Coefficient Kernel Machine Regression and Bayesian Kernel Machine Regression (BKMR) were used to evaluate metal mixture impacts on baseline and longitudinal changes in BP (from ages 4 to 11) and the development of elevated BP at age 11, respectively. BKMR results were compared using static versus percentile-based cutoffs to define elevated BP. Results Molybdenum and lead were the mixture components most consistently associated with BP. J-shaped relationships were observed between molybdenum and both systolic and diastolic BP at age 4. Similar associations were identified for both molybdenum and lead in relation to elevated BP at age 11. For molybdenum concentrations above the inflection points (~ 40–80 μg/L), positive associations with BP at age 4 were stronger at high levels of lead. Lead was positively associated with BP measures at age 4, but only at high levels of molybdenum. Potential interactions between molybdenum and lead were also identified for BP at age 11, but were sensitive to the cutoffs used to define elevated BP. Conclusions Prenatal exposure to high levels of molybdenum and lead, particularly in combination, may contribute to higher BP at age 4. These early effects appear to persist throughout childhood, contributing to elevated BP in adolescence. Future studies are needed to identify the major sources of molybdenum and lead in this population.

Lagged Kernel Machine Regression For Identifying Time Windows Of Susceptibility To Exposures Of Complex Metal Mixtures

2015 ◽  
Vol 2015 (1) ◽  
pp. 1820
Author(s):  
Shelley H. Liu ◽  
Jennifer F. Bobb ◽  
Kyu Ha Lee ◽  
Chris Gennings ◽  
Birgit Claus Henn ◽  
...  
Keyword(s):  
Time Windows ◽  
Metal Mixtures ◽  
Kernel Machine ◽  
Complex Metal ◽  
Kernel Machine Regression ◽  
Windows Of Susceptibility

scholarly journals In Utero Exposure to Heavy Metals and Trace Elements and Childhood Blood Pressure in a U.S. Urban, Low-Income, Minority Birth Cohort

2021 ◽  
Vol 129 (6) ◽  
pp. 067005 ◽  
Author(s):  
Mingyu Zhang ◽  
Tiange Liu ◽  
Guoying Wang ◽  
Jessie P. Buckley ◽  
Eliseo Guallar ◽  
...  
Keyword(s):  
Heavy Metals ◽  
Blood Pressure ◽  
Trace Elements ◽  
Birth Cohort ◽  
Low Income ◽  
In Utero ◽  
In Utero Exposure ◽  
Metals And Trace Elements

Abstract MP64: Higher Visit-to-Visit Blood Pressure Variability In Early And Middle Childhood Is Associated With Higher Blood Pressure In Adolescence

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Mingyu Zhang ◽  
Lawrence J Appel ◽  
Xiaobin Wang ◽  
Noel T Mueller
Keyword(s):  
Blood Pressure ◽  
Birth Cohort ◽  
Middle Childhood ◽  
Linear Regression Models ◽  
Primordial Prevention ◽  
Predominantly Minority ◽  
Independent Risk Factors ◽  
The Mean ◽  
Incident Cardiovascular Disease ◽  
Multivariable Adjustment

Background: In young adults, higher blood pressure (BP) and visit-to-visit BP variability are independent risk factors for incident cardiovascular disease. No studies have examined if BP and visit-to-visit BP variability during early and middle childhood are independently associated with elevated BP during adolescence. Addressing this question can provide targets for primordial prevention of high BP. Hypotheses: Higher BP and BP variability in early and middle childhood are independently associated with higher BP in adolescence. Methods: We studied 476 children in the Boston Birth Cohort (enrolled 1998-2016) who had BP measured in early (1 to <6 y) or middle childhood (6 to <13y) and in adolescence (13 to <18 y). We modelled visit-to-visit BP variability using variability independent of the mean (VIM). We used linear regression models to examine the associations of mean BP and BP VIM in early and middle childhood (exposures) with mean BP in adolescence (outcome) and adjusted for potential confounders (see Table footnote). Results: After multivariable adjustment, a 1-SD higher level of systolic BP (SBP) in early and middle childhood was associated with a 1.89 (95% CI: 1.03, 2.75) and a 4.31 (95% CI: 3.58, 5.03) mmHg higher SBP in adolescence, respectively. A 1-SD higher level of SBP VIM in early and middle childhood was associated with a 1.46 (95% CI: 0.54, 2.38) and a 0.89 (95% CI: 0.05, 1.73) mmHg higher SBP in adolescence, respectively. Higher diastolic BP (DBP) in early and middle childhood was also associated with higher adolescence DBP, but the magnitude was smaller in comparison with SBP results ( Table ). Childhood DBP VIM was not associated with DBP in adolescence. Conclusion: In this prospective US predominantly minority birth cohort, both BP levels and variability during early and middle childhood are associated with higher BP in adolescence. Our findings underscore the need for health professionals to collect early-life BP data to facilitate opportunities for the primordial prevention of high BP in adolescence and beyond.

The Effects of Mean of Visit-to-Visit Blood Pressure on Incident Brain Vascular Lesions and Functional-Cognitive Decline

2021 ◽  
pp. 1-12
Author(s):  
Bibek Gyanwali ◽  
Celestine Xue Ting Cai ◽  
Christopher Chen ◽  
Henri Vrooman ◽  
Chuen Seng Tan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cognitive Decline ◽  
Hippocampal Volume ◽  
Intracranial Stenosis ◽  
Vascular Lesions ◽  
Linear Regression Models ◽  
Volume Functional ◽  
Mri Scans ◽  
The Mean

Background: Cerebrovascular disease (CeVD) is an underlying cause of cognitive impairment and dementia. Hypertension is a known risk factor of CeVD, but the effects of mean of visit-to-visit blood pressure (BP) on incident CeVD and functional-cognitive decline remains unclear. Objective: To determine the association between mean of visit-to-visit BP with the incidence and progression of CeVD [white matter hyperintensities (WMH), infarcts (cortical infarcts and lacunes), cerebral microbleeds (CMBs), intracranial stenosis, and hippocampal volume] as well as functional-cognitive decline over 2 years of follow-up. Methods: 373 patients from a memory-clinic underwent BP measurements at baseline, year 1, and year 2. The mean of visit-to-visit systolic BP, diastolic BP, pulse pressure, and mean arterial pressure were calculated. Baseline and year 2 MRI scans were graded for WMH, infarcts, CMBs, intracranial stenosis, and hippocampal volume. Functional-cognitive decline was assessed using locally validated protocol. Logistic and linear regression models with odds ratios, mean difference, and 95%confidence interval were constructed to analyze associations of visit-to-visit BP on CeVD incidence and progression as well as functional-cognitive decline. Results: Higher mean of visit-to-visit diastolic BP was associated with WMH progression. Higher tertiles of diastolic BP was associated with WMH progression and incident CMBs. There was no association between mean of visit-to-visit BP measures with incident cerebral infarcts, intracranial stenosis, change in hippocampal volume, and functional-cognitive decline. Conclusion: These findings suggest the possibility of hypertension-related vascular brain damage. Careful monitoring and management of BP in elderly patients is essential to reduce the incidence and progression of CeVD.

scholarly journals Caesarean delivery is associated with increased blood pressure in young adult offspring

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Amaraporn Rerkasem ◽  
Sarah E. Maessen ◽  
Antika Wongthanee ◽  
Sakda Pruenglampoo ◽  
Ampica Mangklabruks ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Young Adults ◽  
Birth Cohort ◽  
Fasting Blood Glucose ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Adjusted Relative Risk ◽  
Obesity Risk ◽  
Chiang Mai ◽  
Clinical Assessments

AbstractWe examined the associations between caesarean section (CS) delivery and cardiovascular risk factors in young adults in Thailand. Participants were 632 offspring from a birth cohort in Chiang Mai (Northern Thailand), born in 1989–1990 and assessed in 2010 at a mean age of 20.6 years, including 57 individuals (9.0%) born by CS and 575 born vaginally. Clinical assessments included anthropometry, blood pressure (BP), carotid intima-media thickness, and fasting blood glucose, insulin, and lipid profile. Young adults born by CS had systolic BP (SBP) 6.2 mmHg higher (p < 0.001), diastolic BP 3.2 mmHg higher (p = 0.029), and mean arterial pressure (MAP) 4.1 mmHg higher (p = 0.003) than those born vaginally. After covariate adjustments, SBP and MAP remained 4.1 mmHg (p = 0.006) and 2.9 mmHg (p = 0.021) higher, respectively, in the CS group. The prevalence of abnormal SBP (i.e., pre-hypertension or hypertension) in the CS group was 2.5 times that of those born vaginally (25.0% vs 10.3%; p = 0.003), with an adjusted relative risk of abnormal SBP 1.9 times higher (95% CI 1.15, 2.98; p = 0.011). There were no differences in anthropometry (including obesity risk) or other metabolic parameters. In this birth cohort in Thailand, CS delivery was associated with increased blood pressure in young adulthood.

scholarly journals Discordant twin growth in utero and differences in blood pressure and endothelial function at 8 years of age

2006 ◽  
Vol 259 (2) ◽  
pp. 155-163 ◽  
Author(s):  
C. P. HALVORSEN ◽  
E. ANDOLF ◽  
J. HU ◽  
C. PILO ◽  
B. WINBLADH ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Endothelial Function ◽  
In Utero ◽  
Twin Growth ◽  
Discordant Twin

scholarly journals Association between egg intake and blood pressure in the USA: the INTERnational study on MAcro/micronutrients and blood Pressure (INTERMAP)

2021 ◽  
pp. 1-9
Author(s):  
Thanh-Huyen T Vu ◽  
Linda Van Horn ◽  
Martha L Daviglus ◽  
Queenie Chan ◽  
Alan R Dyer ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Dietary Cholesterol ◽  
International Study ◽  
Obese Women ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Men And Women ◽  
The Usa ◽  
Underlying Mechanisms

Abstract Objectives: To investigate associations of egg intake with blood pressure (BP) and the role of dietary variables and other macro- and micro-nutrients in the association. Design: We used cross-sectional data for the USA as part of the INTERnational study on MAcro/micronutrients and blood Pressure (INTERMAP). INTERMAP was surveyed between 1996 and 1999, including four 24-h dietary recalls, two 24-h urine collections and eight measurements of systolic BP and diastolic BP (SBP, DBP). Average egg intake (g/d) was calculated. Multivariable linear regression models were used to estimate the association between egg intake (per each 50 g/d or per quintile) and BP. The roles of dietary variables and other macro- and micro-nutrients in this association were also investigated. Setting: In the USA. Participants: In total, 2195 US INTERMAP men and women aged 40–59 years. Results: Participants were 50 % female, 54 % non-Hispanic White and 16 % non-Hispanic Black. Mean egg intake (sd) in men and women was 30·4(29·8) and 21·6(20·5) g/d, respectively. Adjusting for demographics, socio-economics, lifestyle and urinary Na:K excretion ratios, we found non-linear associations with BP in non-obese women (P-quadratic terms: 0·004 for SBP and 0·035 for DBP).The associations remained after adjusting for dietary variables, macro/micro nutrients or minerals. Dietary cholesterol was highly correlated with egg intake and may factor in the association. No association was found in obese women and in obese or non-obese men. Conclusion: Egg intake was non-linearly associated with SBP and DBP in non-obese women, but not in obese women or men. Underlying mechanisms require additional study regarding the role of obesity and sex.

Dairy intake, blood pressure and incident hypertension in a general British population: the 1946 birth cohort

2011 ◽  
Vol 51 (5) ◽  
pp. 583-591 ◽  
Author(s):  
Alexandros Heraclides ◽  
Gita D. Mishra ◽  
Rebecca J. Hardy ◽  
Johanna M. Geleijnse ◽  
Stephanie Black ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Birth Cohort ◽  
Incident Hypertension ◽  
Dairy Intake
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