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Association between preeclampsia in daughters and risk of cardiovascular disease in parents
Frederikke Lihme1, Saima Basit1, Lucca Katrine Sciera1
1Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark.
Insights
Preeclampsia in daughters increases parents' cardiovascular disease (CVD) risk, suggesting shared genetic factors. The risk rises with more daughters affected and is higher for early-onset CVD.
Area of Science:
- Reproductive Medicine
- Cardiovascular Medicine
- Genetics and Heritability
Background:
- Preeclampsia and cardiovascular disease (CVD) are significant health concerns.
- Emerging evidence suggests potential shared underlying mechanisms between preeclampsia and CVD.
- Heritable factors may play a role in the predisposition to both conditions.
Purpose of the Study:
- To investigate the association between preeclampsia in daughters and the risk of developing CVD in their parents.
- To explore whether shared heritable mechanisms contribute to both preeclampsia and parental CVD.
- To examine the influence of the number of affected daughters and the age of CVD onset on this association.
Main Methods:
- A large-scale, register-based cohort study in Denmark (1978-2018) involving 1,299,310 parents.
- Cox regression analysis was used to compare CVD incidence rates in parents with daughters who had preeclampsia versus those without.
- Cardiovascular disease outcomes included ischemic heart disease, ischemic stroke, and myocardial infarction.
Main Results:
- Parents with at least one daughter who had preeclampsia showed a significantly increased risk of developing CVD.
- The hazard ratio for CVD was 1.19 for parents with one affected daughter and 1.88 for those with two or more affected daughters.
- Stronger associations were observed for CVD occurring before age 55 and were similar for mothers and fathers.
Conclusions:
- Preeclampsia in daughters is associated with an elevated risk of cardiovascular disease in parents.
- The findings support the hypothesis that preeclampsia and CVD share common heritable underlying mechanisms.
- The dose-response relationship and earlier onset associations highlight the potential genetic link.
Abstract:
Preeclampsia and cardiovascular disease (CVD) might share heritable underlying mechanisms. We investigated whether preeclampsia in daughters is associated with CVD in parents. In a register-based cohort study, we used Cox regression to compare rates of CVD (ischemic heart disease, ischemic stroke, myocardial infarction) in parents with ≥ 1 daughters who had preeclampsia and parents whose daughters did not have preeclampsia in Denmark, 1978-2018. Our cohort included 1,299,310 parents, of whom 87,251 had ≥ 1 daughters with preeclampsia and 272,936 developed CVD during 20,252,351 years of follow-up (incidence rate 135/10,000 person-years). Parents with one daughter who had preeclampsia were 1.19 times as likely as parents of daughters without preeclampsia to develop CVD at age < 55 years (hazard ratio [HR] 1.19, 95% confidence interval [CI] 1.13-1.25). Having ≥ 2 daughters who had preeclampsia yielded an HR of 1.88 (95% CI 1.39-2.53). The corresponding HRs for CVD at ≥ 55 years of age were 1.13 (95% CI 1.12-1.15) and 1.27 (95% CI 1.16-1.38). Patterns of association were similar for all CVD subtypes. Effect magnitudes did not differ for mothers and fathers (p = 0.52). Analyses by timing of preeclampsia onset in daughters suggested a tendency toward stronger associations with earlier preeclampsia onset, particularly in parents < 55 years. Preeclampsia in daughters was associated with increased risks of CVD in parents. Increasing strength of association with increasing number of affected daughters, equally strong associations for mothers and fathers, and stronger associations for CVD occurring before age 55 years suggest that preeclampsia and CVD share common heritable mechanisms.
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