Key result
Vascular structure shows significant heritability across African generations, but blood pressure does not.
Why the study?
Cardiovascular disease is increasing in low- and middle-income countries, including Africa, motivating the need to determine the heritability of cardiovascular risk markers across three generations to inform prevention strategies in South Africa.
Are phenotypic measures of cardiovascular health heritable across three generations of families in South Africa?
Cross-Sectional (n=195)
No
Are phenotypic measures of cardiovascular health heritable across three generations of families in South Africa?
Identification of structural vascular health indicators such as elevated cIMT or LVH in adults may be a useful trigger for cardiovascular risk screening in younger family members.
May support family screening for structural traits in African cohorts; extends heritability data to three generations but leaves clinical utility open.
Objectives Cardiovascular disease is increasing in many low and middle-income countries, including those in Africa. To inform strategies for the prevention of cardiovascular disease in South Africa, we sought to determine the broad heritability of phenotypic markers of cardiovascular risk across three generations. Design A cross-sectional study conducted in a longitudinal family cohort. Setting Research unit within a tertiary hospital in a historically disadvantaged, large urban township of South Africa. Participants 195 individuals from 65 biological families with all three generations including third-generation children aged 4–10 years were recruited from the longest running intergenerational cohort study in Africa, the Birth to Twenty Plus cohort. All adults (grandparents and parents) were female while children were male or female. Primary and secondary outcome measures The primary outcome was heritability of blood pressure (BP; brachial and central pressures). Secondary outcomes were heritability of arterial stiffness (pulse wave velocity), carotid intima media thickness (cIMT) and left ventricular mass indexed to body surface area (LVMI). Results While no significant intergenerational relationships of BP or arterial stiffness were found, there were significant relationships in LVMI across all three generations (p<0.04), and in cIMT between grandparents and parents (p=0.0166). Heritability, the proportion of phenotypic trait variation attributable to genetics, was estimated from three common statistical methods and ranged from 23% to 44% for cIMT and from 21% to 39% for LVMI. Conclusions Structural indicators of vascular health, which are strong markers of future clinical cardiovascular outcomes, transmit between generations within African families. Identification of these markers in parents may be useful to trigger assessments of preventable risk factors for cardiovascular disease in offspring.
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Ware et al. (2022) conducted a cross-sectional in Cardiovascular risk markers (n=195). Intergenerational family relationship vs. Random non-biological pairings was evaluated on Heritability of blood pressure (brachial and central pressures) (No significant intergenerational relationships found). Structural indicators of vascular health, including left ventricular mass index (21-39% heritability) and carotid intima media thickness (23-44%), demonstrated significant heritability across generations in African families, while blood pressure did not.
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