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The inheritance of cardiovascular disease risk
Mark Hanson1,2
1Institute of Developmental Sciences, University of Southampton, Southampton, UK.
Insights
Cardiovascular disease (CVD) risk can be transmitted across generations through biological and social factors. Early, intergenerational interventions before and during pregnancy are crucial for preventing lifelong CVD risk.
Area of Science:
- Public Health
- Genetics
- Maternal Health
Background:
- Cardiovascular disease (CVD) is a leading cause of non-communicable disease (NCD) deaths globally, contributing to 71% of annual fatalities.
- CVD is a significant factor in maternal mortality (25%) and is associated with gestational diabetes and pre-eclampsia.
- Prenatal factors, including maternal diet and body composition, are linked to early CVD risk markers in children, mediated by epigenetic changes.
Purpose of the Study:
- To highlight the intergenerational transmission of cardiovascular disease (CVD) risk.
- To emphasize the critical need for early, life-course preventive interventions for NCDs.
- To advocate for greater emphasis on preconception, pregnancy, and postpartum interventions in global NCD strategies.
Main Methods:
- Review of existing literature on cardiovascular disease (CVD) risk factors and intergenerational transmission.
- Analysis of the role of epigenetic mechanisms in mediating CVD risk across generations.
- Examination of current global NCD policies and their limitations.
Main Results:
- Cardiovascular disease (CVD) risk is transmitted across generations via biological and socio-economic pathways, influenced by epigenetic modifications.
- Early life and prenatal factors significantly impact long-term CVD risk trajectories.
- Current global strategies for NCDs inadequately address crucial intergenerational preventive opportunities.
Conclusions:
- Preventive strategies for cardiovascular disease (CVD) must begin before conception and extend through postpartum life stages.
- Addressing socio-economic factors and promoting healthy behaviors in prospective parents and during pregnancy is essential.
- There is a need for a broader societal and individual responsibility framework for the health of future generations regarding NCDs.
Abstract:
Cardiovascular disease (CVD) is foremost among the non-communicable diseases (NCDs) which account for 71% of deaths globally each year. CVD is also prominent among the pre-existing conditions still accounting for nearly 25% of maternal deaths and is linked to gestational diabetes and pre-eclampsia. Markers of CVD risk have been reported even in young children, related to prenatal factors such as mother's diet or body composition. The underlying mechanisms include epigenetic changes which can alter the trajectory of risk across the life course. Preventive interventions need to commence before conception, to reduce transmission of CVD risk by promoting healthy behaviours in prospective parents, as well as in pregnancy, and postpartum through breastfeeding and healthy complementary feeding. Surprisingly, these opportunities are not emphasised in the 2018 United Nations Political Declaration on NCDs. NCDs such as CVD have communicable risk components transmitted across generations by socio-economic as well as biological factors, although the former can also become embodied in the offspring by epigenetic mechanisms. The inheritance of CVD risk, and social inequalities in such risk, thus raises wider questions about responsibility for the health of future generations at societal as well as individual levels.
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