Abstract

BackgroundAtherosclerotic remodeling starts early in life and can accelerate in the presence of cardiovascular risk (CV) factors. Regular physical activity (PA) can mitigate development of large and small artery disease during lifespan. We aimed to investigate the association of changes in body mass index (BMI), blood pressure (BP), PA behavior and retinal microvascular diameters with large artery pulse wave velocity (PWV) in prepubertal children over 4 years.MethodsThe school-based prospective cohort study included 262 children initially aged 6–8 years, assessing the above CV risk factors and retinal vessels by standardized procedures at baseline (2014) and follow-up (2018). PWV was assessed by an oscillometric device at follow-up.ResultsChildren with increased systolic BP over 4 years showed higher PWV at follow-up (β [95% CI] 0.006 [0.002 to 0.011] mmHg per unit, P = 0.002). In contrast, increased vigorous PA corresponded to a lower PWV at follow-up (β [95% CI] −0.009 [−0.018 to <0−0.001] 10 min/day per unit, P = 0.047). Progression of retinal arteriolar narrowing and venular widening were linked to a higher PWV after 4 years (β [95% CI] −0.014 [−0.023 to −0.004] 0.01 changes per unit, P = 0.003).ConclusionIncrease in systolic BP and progression of microvascular dysfunction were associated with higher PWV after 4 years. Children with increasing levels of vigorous PA were found to have lower PWV at follow-up. Habitual vigorous PA has the potential to decelerate the process of early vascular aging in children and may thus help counteract CV disease development later in life.Clinical Trial RegistrationClinicalTrials.gov, Identifier: NCT03085498.

Highlights

  • Regular physical activity (PA) and fitness are well known for their protective effect against cardiovascular (CV) disease development in adulthood (Lear et al, 2017). 150 min of moderate PA per week are recommended in adults (World Health Organization, 2010) and attributed to a reduced risk of CV morbidity and mortality by 22% (Lear et al, 2017)

  • We aimed to investigate the association of changes in body mass index (BMI), blood pressure (BP), PA behavior and retinal microvascular diameters with large artery pulse wave velocity (PWV) in prepubertal children over 4 years

  • Increased vigorous PA corresponded to a lower PWV at follow-up (β [95% confidence intervals (CI)] −0.009 [−0.018 to

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Summary

Introduction

Regular physical activity (PA) and fitness are well known for their protective effect against cardiovascular (CV) disease development in adulthood (Lear et al, 2017). 150 min of moderate PA per week are recommended in adults (World Health Organization, 2010) and attributed to a reduced risk of CV morbidity and mortality by 22% (Lear et al, 2017). 150 min of moderate PA per week are recommended in adults (World Health Organization, 2010) and attributed to a reduced risk of CV morbidity and mortality by 22% (Lear et al, 2017). An increase in 1 kg/m2 body mass index (BMI) accounts for 1.4 mmHg higher systolic BP in prepubertal children (Falaschetti et al, 2010). Both risk factors track from childhood into adulthood (Chen and Wang, 2008; Simmonds et al, 2016) and may initiate early onset of chronic CV disease and premature CV mortality (Berenson, 2002; Franks and Bennett, 2010). We aimed to investigate the association of changes in body mass index (BMI), blood pressure (BP), PA behavior and retinal microvascular diameters with large artery pulse wave velocity (PWV) in prepubertal children over 4 years

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