Correlation between anti-Müllerian hormone, hypertension and vascular age: the Generation R Study, a population-based prospective cohort study

OBJECTIVE: The objective of this study was to explore the relationship between levels of anti-Müllerian hormone (AMH) and the risk of hypertension and vascular ageing in a population-based cohort. STUDY DESIGN: This study was embedded in the Generation R Study, a prospective population-based cohort study of children and their parents in the City of Rotterdam, the Netherlands. The present study included all women at the first recall visit with available data on AMH and blood pressure (n = 4883) and analysed the association between AMH and hypertension. AMH levels (first recall visit) and carotid artery intima-medial thickness (CIMT) measurements (second recall visit) were used to analyse the association between AMH serum levels and CIMT as a proxy for vascular age (n = 3508). RESULTS: A higher age and lower AMH percentiles (adjusted for age) were associated with an increased risk of hypertension. Women with AMH percentiles <p10 had a 2.1 times higher risk of hypertension than women with AMH levels >p90 (P < .001). Vascular age, conducted from CIMT measurements (second recall visit), was on average 9.8 years older than chronological age in those with an AMH below p10 (first recall visit). This difference was 6.1 years in those with an AMH exceeding p90. Similarly, differences in medians between the groups were significant (p < 0,008). CONCLUSIONS: This large prospective cohort study shows that low AMH levels later in life, independent of age, are associated with hypertension. The results indicate that diminished ovarian reserve at a younger age is associated with indicators of vascular alterations. Women with low AMH levels should not only be counseled about potential fertility issues, but should also be informed about their increased risk of vascular damage in order to take appropriate preventive measures. In the future, AMH may serve as a prospective marker for the early detection of cardiovascular diseases.