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Developmental programming of cardiovascular disorders: focus on hypertension
Sheba M J MohanKumar1, Andrew King, Andrew C Shin
1Department of Pharmacology and Toxicology, Michigan State University, E. Lansing, MI 48824, USA. mohankumrs@cvm.msu.edu
Insights
Maternal nutrition during pregnancy, particularly obesity, may program offspring for adult hypertension. Factors like inflammation and hormonal changes in obese mothers could influence fetal development, leading to cardiovascular risks later in life.
Area of Science:
- Reproductive biology
- Endocrinology
- Cardiovascular science
Background:
- Adult cardiovascular disorders like hypertension may originate from in utero programming.
- Mechanisms linking fetal development to adult cardiovascular disease require further elucidation.
- Maternal factors such as nutrition and endocrine signaling are implicated in fetal programming.
Purpose of the Study:
- To review the role of maternal nutrition, sex steroids, and endocrine factors in programming adult hypertension.
- To explore mechanisms contributing to hypertension development in offspring.
- To emphasize the impact of maternal overnutrition and obesity on fetal programming.
Main Methods:
- Literature review focusing on maternal nutrition, endocrine factors, and fetal programming.
- Discussion of potential mechanisms including sympathetic and renin-angiotensin system activity, nephron development.
- Analysis of the effects of maternal obesity, inflammation, leptin resistance, and glucocorticoid levels.
Main Results:
- Maternal undernutrition has been a focus, but maternal overnutrition is increasingly recognized.
- Obesity is linked to increased proinflammatory cytokines and leptin resistance.
- Dysregulation of the hypothalamo-pituitary-adrenal axis and elevated glucocorticoids are associated with maternal obesity.
Conclusions:
- Maternal obesity may significantly contribute to programming hypertension in offspring.
- Inflammatory and endocrine changes in obese mothers could be key programming factors.
- In utero exposure to factors associated with maternal obesity may lead to adult cardiovascular risks.
Abstract:
Increasing evidence suggests that adult cardiovascular disorders, e.g. hypertension, can be "programmed" in utero. The mechanisms that affect the developing fetus and lead to future cardiovascular disease are not fully established. This review addresses the possible involvement of maternal nutrition, sex steroids and other endocrine factors in the programming of hypertension in adulthood. Some possible mechanisms of subsequent development of hypertension in adulthood, such as elevated sympathetic and renin-angiotensin system activity, and failure of nephron development, also are discussed. Previous studies suggest that maternal undernutrition could be a major factor in fetal programming, but in light of the increased worldwide prevalence of obesity, maternal overnutrition is now receiving increased attention. Special emphasis is given here to this phenomenon. Obesity is associated with increased serum and tissue levels of proinflammatory cytokines, and loss of sensitivity to the adipokine leptin. It is postulated that this causes dysregulation of the hypothalamo-pituitary-adrenal axis, resulting in increased levels of circulating glucocorticoids. These factors could play a major role in programming, during the in utero period, of future hypertension in the offspring of obese mothers.
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