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- Timpka, Simon, et al.
(författare)
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Hypertensive disorders of pregnancy and offspring cardiac structure and function in adolescence
- 2016
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Ingår i: Journal of the American Heart Association. - 2047-9980. ; 5:11
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Tidskriftsartikel (refereegranskat)abstract
- Background-Fetal exposure to preeclampsia is associated with higher blood pressure and later risk of stroke. We aimed to investigate the associations of maternal preeclampsia, gestational hypertension, and maternal blood pressure change in pregnancy with offspring cardiac structure and function in adolescence. Methods and Results-Using data from a prospective birth cohort study, we included offspring who underwent echocardiography (mean age, 17.7 years; SD, 0.3; N=1592). We examined whether hypertensive disorders of pregnancy were associated with offspring cardiac structure and systolic/diastolic function using linear regression. Using multilevel linear spline models (measurement occasions within women), we also investigated whether rate of maternal systolic/diastolic blood pressure change during pregnancy (weeks 8-18, 18-30, 30-36, and 36 or more) were associated with offspring outcomes. Main models were typically adjusted for maternal age, offspring age and sex, prepregnancy body mass index, parity, glycosuria/diabetes mellitus, education, and maternal smoking. Exposure to maternal preeclampsia (0.025; 95% CI, 0.008-0.043) and gestational hypertension (0.010; 0.002-0.017) were associated with greater relative wall thickness. Furthermore, preeclampsia was also associated with a smaller left ventricular end-diastolic volume (-9.0 mL; -15 to -3.1). No associations were found between hypertensive disorders of pregnancy and offspring cardiac function. Positive rate of maternal systolic blood pressure change during weeks 8 to 18 was associated with greater offspring left ventricular end-diastolic volume, left ventricular mass indexed to height2.7, and E/A. Conclusions-Adolescent offspring exposed to maternal preeclampsia had greater relative wall thickness and reduced left ventricular end-diastolic volume, which could be early signs of concentric remodeling and affect future cardiac function as well as risk of cardiovascular disease.
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| 3. |
- Timpka, Simon
(författare)
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Muscle strength and physical education: epidemiological studies of factors in adolescence and their association with later morbidity
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Although Physical Education (PE) is a part of the school curriculum in many countries, the association between the performance in PE and later morbidity is largely unknown. An important marker of health, cardiorespiratory fitness is inversely associated with future cardiovascular disease (CVD) and mortality. It has been suggested that muscle strength is associated in a similar way. However, whether low muscle strength in youth is a risk factor for CVD independently of cardiorespiratory fitness is not known. In a cohort of men and women, I investigated the association between PE performance in adolescence and morbidity in middle age (paper I and II). In cohorts of adolescent men, I investigated isometric muscle strength as a risk factor for later musculoskeletal pain (paper III), CVD, and mortality (paper IV). In women, low PE performance was associated with having a musculoskeletal diagnosis as well as with increased sick leave and increased number of physician visits. Men with low muscle strength did not have an increased risk for musculoskeletal pain but an increased risk of ischemic CVD as well as middle age CVD mortality. Notably, the associations were independent of cardiorespiratory fitness. In summary, I conclude the following 1) Adolescent girls with low PE performance could be important to target with early interventions to reduce future musculoskeletal illness and health impairment. 2) General isometric muscle strength in youth is not a risk factor for adult musculoskeletal pain in men. 3) The role of muscle strength in the development of CVD warrants further attention.
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