Abstract-Cardiovascular risk factors affecting arterial stiffness in adulthood may develop at different critical periods earlier in life. We examined whether the trajectories, from adolescence to young adulthood, of blood pressure, body fatness and fat distribution, blood lipids, cardiorespiratory fitness, and heart rate determined levels of arterial stiffness in young adults. We investigated 373 apparently healthy adults in whom cardiovascular risk factors were repeatedly examined between the ages of 13 and 36 years and carotid stiffness estimates were obtained at the age of 36 years. Differences in the mean levels and the trajectories of risk factors throughout the 24-year longitudinal period between subjects with different levels of carotid stiffness at age 36 years were analyzed with generalized estimating equations. Compared with individuals with less stiff carotid arteries, those with stiffer carotid arteries at the age of 36 years were characterized from ages 13 to 36 years by greater levels of and steeper increases in blood pressure and central fatness, independently of each other and other risk factors. These increases were already present in adolescence, preceded the development of poorer levels of blood lipids, cardiorespiratory fitness, and heart rate, which were evident during adulthood only, and explained to a great extent the deleterious association between these risk factors and carotid stiffness at the age of 36 years. Multiple and intertwined mechanisms involved in the pathogenesis of arterial stiffness have their origins in early life. Blood pressure and central fatness have a pivotal role herein and should be specifically targeted to prevent arterial stiffening and its cardiovascular sequelae. A rterial stiffness is an important cause of cardiovascular disease because of its contribution to systolic hypertension, left ventricular hypertrophy, and impaired coronary perfusion. 1-3 Arterial stiffness is primarily determined by aging and mean arterial pressure (MAP), 2,4 but other risk factors (RF) may also contribute, notably body fatness and/or a central pattern of fat distribution, 5-8 impaired glucose metabolism and insulin resistance, 2 poor cardiorespiratory fitness, 9,10 and dyslipidemia. 11,12 Recently, a systematic review suggested that the contribution to arterial stiffness of RF other than blood pressure (BP) was only modest, although this evidence was derived from cross-sectional studies only. 13 Therefore, a life-course rather than a single time-point approach to the study of (early) determinants of arterial stiffness is needed.The negligible, if any, role of RF other than BP on arterial stiffness was also emphasized in a prospective analysis conducted among men throughout middle age and older age. 14 However, some evidence suggests that arterial stiffness in adulthood has its roots early in life. Indeed, studies among the young have shown that greater levels of BP 15,16 and body fatness and/or a central pattern of fat distribution 5,15,17 measured in childhood/adolescence were as...

Abstract-Higher levels of habitual physical activity favorably impact on arterial stiffness. It is not clear, however, whether lifetime habitual physical activities of different intensities carry the same protective effect and to what extent any such effect is mediated by other biological cardiovascular risk factors. We, therefore, examined longitudinal data on habitual physical activity and cardiovascular risk factors (8 repeated measures between the ages of 13 and 36 years) in 373 subjects in whom stiffness estimates of the carotid artery were assessed at age 36 years using noninvasive ultrasonography. The time spent in habitual physical activities (in minutes per week) throughout the longitudinal period was compared between subjects across tertiles of the following stiffness estimates: ␤-stiffness index, distensibility and compliance coefficients, and the Young's elastic modulus. After adjustments for sex, body height, and other lifestyle variables, subjects in the highest tertile of the ␤-stiffness index (ie, with stiffer arteries) had spent, on average, throughout the longitudinal period, less time in vigorous (Ϫ26.

The change in arterial stiffness over the cardiac cycle, rather than diastolic stiffness, is independently associated with LVMI in healthy middle-aged individuals. Therefore, the pressure dependency of arterial stiffness should be considered in cardiovascular risk assessment.

Lifetime vigorous, but not light-to-moderate, HPA is favorably associated with brachial and femoral compliance, but not DC. Altogether, these and our previous findings thus suggest generalized vigorous-HPA-related adaptations, although of different nature, throughout the arterial tree.