Research examining how cardiometabolic risk factors in pregnant women may affect the blood pressure (BP) of their offspring and the association between early childhood food insecurity and future cardiovascular health were published May 7 in JAMA Network Open and May 14 in JAMA Cardiology, respectively.

The first study found that the offspring of women with hypertensive disorders of pregnancy, alone or combined with either prepregnancy obesity or gestational diabetes, were more likely to have higher BP.

Zhongzheng Niu, PhD, et al., included 12,480 mother-offspring pairs (mean age 30 years during pregnancy, 16% Black), 45% of whom had at least one maternal cardiometabolic risk factor. The investigators analyzed offspring systolic BP (SBP) and diastolic BP (DBP) percentiles, adjusting for age, sex and height.

At their first BP measurement, offspring born to mothers with any cardiometabolic risk factors had higher SBP (4.88 percentile points; 95% CI, 3.97-5.82 percentile points) and DBP (1.90 percentile points; 95% CI, 1.15-2.64 percentile points) compared to those without any risk factors.

This association was even more pronounced among female offspring when compared to male offspring and in Black patients in contrast to other racial and ethnic groups.

"Offspring born to mothers with cardiometabolic risk factors not only had a higher [BP] at a younger age, but such differences also were further amplified as they grew up," note the authors. In cases where two or more BP measurements were taken, maternal cardiometabolic risk factors were associated with an increased rate of BP change from age 2 to 18 years (SBP percentile, 0.5 [95% CI, 0.2-0.8] per year; DBP percentile, 0.7 [95% CI 0.5-1.0] per year).

"[These findings] add substantively to the overwhelming evidence that an individual's lifelong health is influenced by the intrauterine environment," write Jennifer H. Klein, MD, MPH, and Michele Mietus-Snyder, MD, in an accompanying editorial comment. "This work further shows that maternal cardiometabolic risk factors may have an additive association with child cardiovascular health."

The other study observed an association between early childhood food insecurity and worse cardiovascular health in young adulthood.

Emily L. Lam, BA, et al., included 1,071 participants (53% female, 39% lived in food insecure households, 44% participated in Supplemental Nutrition Assistance Program [SNAP]), using the U.S. Department of Agriculture Food Insecurity survey to determine food insecurity status and the American Heart Association Life's Essential 8 (LE8) score, component LE8 scores and clinical cardiovascular health risk factors to measure cardiovascular health.

Results showed those with early childhood food insecurity were more likely to have a lower LE8 score as a young adult (β, –2.2 [95% CI, –4.0 to –0.4]). An even stronger association between food insecurity and lower LE8 scores was observed among households that did not participate in SNAP (β, –4.9 [95% CI, –7.6 to –2.3]).

Their analysis of component LE8 scores found that childhood food insecurity was associated with a 4.9-point lower LE8 score for BMI (β, –4.9 [95% CI, –9.6 to –0.3]). The other LE8 scores – diet, physical activity, tobacco, cholesterol level, glucose level and blood pressure – did not have significant associations with food insecurity. Food insecurity was also significantly associated with higher odds of having a BMI ≥30 (adjusted odds ratio, 1.40.

"Our findings suggest that early childhood food insecurity may be associated with preclinical obesity as an earlier stage of disease but perhaps not yet the development of clinical obesity alongside other abnormal risk factors, such as hypertension or diabetes," write the authors.