Understanding intergenerational transmission of poor cardiovascular health in Africa (GenHeart Study)

People of African descent have increased risk for hypertension, stroke, and hypertensive disorders in pregnancy. This poor cardiovascular health is in part heritable. Across three generations in South African families (with a prior Welcome seed award) I reported the inherited proportion of phenotypic trait variation was estimated at 23-44% for carotid intima media thickness (cIMT) and 21-39% for cardiac left ventricular mass indexed to body surface area (LVMI). However, the mechanisms underlying this heritability are not well understood and require large, longitudinal studies with data collected in preconception, pregnancy, and early life. This proposal seeks to leverage such a study and to nest cardiovascular phenotyping within assessments at each life stage for parents and offspring. The aims are to evaluate the role of preconception parental vascular compliance, endothelial dysfunction, cardiac and renal function in determining the extent of maternal cardiovascular adaption to pregnancy and the impact on fetal growth, pregnancy outcomes and postpartum maternal and child cardiovascular health in the first 5yrs of life. Further examining the impact of common hazardous exposures (tobacco, poor diet, and air pollution) at each life stage. This highly cost-effective proposal will inform public health policy and intervention strategies to reduce intergenerational disease transmission.