Abstract

Arterial stiffness is an important risk factor for cardiovascular diseases including stroke. It has been established that childhood cardiovascular (CV) risk factors are predictive of adulthood arterial stiffness as measured by pulse wave velocity. Limited information is available on this relationship such as race- and sex-specific differential effects. This aspect was examined in a black-white, longitudinal cohort of 786 adults (28% blacks, 42% men) aged 23-44 years who were examined as both children (age<18 years) and adults (age≥18 years) for traditional CV risk factors with an average follow-up period of 24.2 years. Multiple childhood measurements were averaged and standardized to age-specific z-scores. Brachial-ankle pulse wave velocity (baPWV) measured by an automatic oscillometric technique was used as an index of arterial stiffness in adults. Systolic blood pressure in childhood was predictive of baPWA in adults (P=0.002) in the total cohort. However, nominally significant (P<0.05) childhood predictors of adult baPWV included body mass index (BMI), low-density lipoprotein cholesterol (LDL-C) and systolic blood pressure in white men; systolic blood pressure in white women; and BMI in black women. For race difference, childhood LDL-C tended to show a stronger effect on baPWA in adults in whites than in blacks (P=0.04). For sex difference, BMI tended to be a stronger predictor and LDL-C a weaker predictor in women than in men (P=0.0002 and P=0.003, respectively). Such differences persisted even after adjustment for adulthood risk factors (P<0.05 in all cases). In conclusion, the predictability of childhood CV risk factors for increased arterial stiffness in adulthood varies by race and sex, and this observation indicates that arterial stiffening is different in blacks vs whites and in men vs women.

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