Abstract

OBJECTIVES:To investigate predictors and propose reference equations for the augmentation index normalized to 75 bpm heart rate (AIx@75) in healthy children and adolescents.METHODS:This was a cross-sectional, observational study involving 134 healthy children and adolescents aged 9 to 19 years old. Participants were categorized into child (n=53) and adolescent (n=81) groups, as well as into male (n=69) and female (n=65) groups. We evaluated AIx@75, vascular and hemodynamic parameters, anthropometric data, physical activity profile, and quality of life (Peds-QL4.0; physical, emotional, social and school domains).RESULTS:The predictors of AIx@75 in the whole sample were age, peripheral diastolic blood pressure (pDBP), mean arterial pressure, pulse pressure amplification (PPA), systolic volume (SV), cardiac index (CI), and pulse wave velocity (PWV; R2=80.47%). In the male group, the predictors of AIx@75 were SV, CI, total vascular resistence (TVR), and PWV (R2=78.56%), while in the female group, they were pDBP, PPA, SV, and PWV (R2=82.45%). In the children, they were pDBP, PPA, SV, and PWV (R2=79.17%), while in the adolescents, they were body mass index, pDBP, PPA, SV, TVR, and PWV (R2=81.57%).CONCLUSION:In the present study, we used a representative sample from Belo Horizonte to establish normality values of AIx@75. We also identified, for the first time, independent predictors of AIx@75 in healthy children and adolescents categorized by sex and age. Determining AIx@75 reference equations may facilitate the early diagnosis of preclinical atherosclerosis and allow an objective measure of the vascular effects of therapeutic interventions aimed at modifying cardiovascular risk factors.

Highlights

  • Evidence indicates that atherosclerosis begins in childhood and that risk factors for cardiovascular disease, including diabetes mellitus, hypertension, dyslipidemia, and obesity, are increasing among children and adolescents [1]

  • The female and male groups were similar in all evaluated parameters, while the HC was significantly higher in the adolescent group (Table 1)

  • The augmentation index (AIx)@75 did not correlate with sex, socioeconomic class, or physical activity profile in either children or adolescents

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Summary

Introduction

Evidence indicates that atherosclerosis begins in childhood and that risk factors for cardiovascular disease, including diabetes mellitus, hypertension, dyslipidemia, and obesity, are increasing among children and adolescents [1]. The main markers of arterial structural change are compliance, distensibility, and stiffness. Arterial stiffness can be assessed using central systolic blood pressure (cSBP), augmentation index (AIx), and pulse wave velocity (PWV) [2,3]. No potential conflict of interest was reported. Received for publication on August 19, 2020. Accepted for publication on October 29, 2020

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