Abstract
Background: The central pressure augmentation index (AI) has been suggested as a noninvasive measure of pulsatile load, which is a likely a determinant of left ventricular mass and other cardiovascular outcomes. While adult risk factor associations with AI have been documented, information is scant on the childhood predictors of AI in relatively young and healthy adults. Hypothesis: childhood systolic blood pressure is associated with adult AI. Methods: this aspect was examined in 820 non-institutionalized individuals (65.2% whites, 53.8% females; aged 29.4 - 51.3 years) that participated in the Bogalusa Heart Study and had cardiovascular risk factors information available since childhood. AI was estimated in adulthood through applanation tonometry of the radial artery. The average value of childhood measurements was used as the childhood value, standardized to age, race and sex-specific z-scores. Multivariable linear regression analyses were used to estimate childhood risk factor associations with AI in adulthood. Results: Blacks and males had significantly higher levels of AI in adulthood, compared to their counterparts. After controlling for the effect of age, race and sex, systolic blood pressure (SBP) measured in childhood resulted as the only significant predictor or AI in young adults (β= -0.26, p=0.03). No significant associations were observed in other childhood risk factors such as: high density lipoprotein cholesterol, low density lipoprotein cholesterol, body mass index or diastolic blood pressure. Conclusion: These findings support the hypothesis that SBP in childhood has an impact on adult pulsatile load (as measured by means of AI). Further, this information stresses the importance of primordial prevention of CV risk factors at an early age, as these are responsible of overt cardiovascular disease and complications in adulthood.
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