Assisted reproductive technologies (ARTs), such as in vitro fertilization or intracytoplasmic sperm injection, have been shown to be associated with premature vascular ageing in apparently healthy children, and a new study now shows that this phenotype progresses to arterial hypertension. In developed countries, 2–5% of births are the result of ARTs. Given that ARTs are fairly new, the cohort of individuals born using these techniques is quite young, and the long-term outcomes of ART-induced alterations in vascular function are not well-characterized.
In a study performed by Meister and colleagues, 54 young (mean age 16.5 years), apparently healthy participants conceived by ARTs and 43 age-matched and sex-matched controls underwent assessments of vascular function and 24-h ambulatory blood pressure monitoring. At 5-year follow-up, flow-mediated dilatation was ~25% smaller in the ART group than in controls. This reduction seemed to be related to endothelial dysfunction. Similarly, carotid–femoral pulse wave velocity and carotid intima–media thickness were significantly increased in the ART group compared with controls.
Of note, systolic blood pressure (119.8 mmHg versus 115.7 mmHg) and diastolic blood pressure (71.4 mmHg versus 69.1 mmHg) were significantly higher in the ART group than in controls. Overall, 15.4% of the ART group compared with only 2.5% of the control group fulfilled the diagnostic criteria for arterial hypertension. Blood pressure variability was also increased in the ART group.
“ART causes premature vascular ageing in young, apparently healthy children,” conclude the investigators. “There is increasing evidence that in experimental animals, epigenetic mechanisms contribute to ART-induced alteration of the cardiovascular phenotype.”
Meister, T. A. et al. Association of assisted reproductive technologies with arterial hypertension during adolescence. J. Am. Coll. Cardiol. 72, 1267–1274 (2018)
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Lim, G.B. Assisted reproductive technologies increase risk of hypertension in offspring. Nat Rev Cardiol 15, 656 (2018). https://doi.org/10.1038/s41569-018-0091-z