Association between Pulse Pressure and Carotid Intima-Media Thickness in Healthy Adolescents: Jangseong High School Study

Abstract

Background Wide pulse pressure associates with atherosclerosis, but it is unclear whether pulse pressure within a relatively normal range is associated with atherosclerosis in younger populations. The aim of this study was to investigate the association between pulse pressure and the carotid intima-media thickness (IMT) in healthy adolescents. Methods Study participants included 250 (129 males and 121 females) adolescents who were 17 to 19 years old and in the third grade of a high school in Jangseong, Korea between November 20 and December 1, 2009. Pulse pressure was determined as the difference between systolic blood pressure and diastolic blood pressure which were measured with an oscillometric sphygmomanometer. IMT values were ultrasonographically measured at right and left common carotid arteries, and average of the mean IMT at each artery was used for analysis. Results There was a significant correlation between pulse pressure and carotid IMT before (Pearson coefficient r = 0.2037, p = 0.001) and after (r = 0.1479, p = 0.020) adjustment for sex. When adjusted for sex, age, waist circumference, fasting blood glucose, and total/high-density lipoprotein cholesterol ratio, 10 mm Hg increase in pulse pressure was associated with increase of IMT in total (β = 10.9 µm, p = 0.003), in males (β = 17.3 µm, p < 0.001), but not in females (β = 3.609 µm, p = 0.518). Conclusions This study suggests that higher pulse pressure may be associated with increased carotid IMT even in healthy male adolescents.