AORTIC AND CAROTID STIFFNESS IN CHILDREN AND ADOLESCENTS: RELATIONSHIP AND DETERMINANTS

Abstract

Abstract Objective: Arterial stiffness is an established surrogate measure of preclinical target-organ damage by elevated blood pressure (BP). This study assessed regional (aortic) and local (carotid) arterial stiffness measured by different noninvasive methods in children and adolescents and their relationship with BP levels. Design and method: Apparently healthy children and adolescents (age 6–18 years) referred for elevated BP were evaluated with: (i) office BP (OBP) measurement (3 visits, triplicate readings/visit), (ii) 24 h ambulatory BP (ABP) monitoring, (iii) home BP (HBP) monitoring during daytime and nighttime, (iv) M- and B-mode ultrasonography for the assessment of carotid distensibility coefficient (cCD) and carotid intima-media thickness (cIMT), (v) determination of carotid-femoral pulse wave velocity (cfPWV; Complior). Results: 93 subjects were analyzed (mean age 13.1 ± 2.9 years, 55 males, BMI 24.7 ± 5.2 kg/m2, 18 with 24 h ABP > = 95th percentile). There was an inverse association between cfPWV and cCD (r = -0.42, p < 0.01). Hypertensive subjects had higher PWV than normotensives (6.3 ± 1.0 vs. 5.3 ± 0.9 m/sec respectively, p < 0.01 after adjustment for age and gender), but similar cCD (57.1 ± 47.6 vs. 57.8 ± 18.4 kPa-1/103, p = NS). cfPWV compared to cCD tended to be more strongly correlated with age (r = 0.65 vs. -0.28, p < 0.01 for comparison), systolic OBP (0.60 vs. -0.31, p < 0.01), systolic ABP (24 h/day/nighttime 0.60/0.57/0.49 vs. -0.39/-0.38/-0.31, p = 0.02/0.04/0.07), systolic HBP (day/nighttime 0.48/0.55 vs. -0.33/-0.26, p = 0.13/ < 0.01), cIMT (0.24 vs. -0.08, p = NS), and similarly to BMI (0.28 vs. -0.26, p = NS for comparison). Conclusions: In young individuals aortic PWV as an index of regional stiffness appears to be more closely associated with age and BP levels than local carotid stiffness.