Associations between arterial stiffness and cardiovascular disease risk factors among black South African children

Abstract

This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.Cardiovascular disease (CVD) is the leading cause of mortality and morbidity worldwide and is estimated to cause 17.3 million deaths per year. [1] CVD incidence is strongly associated with a set of conventional risk factors, which include increased waist circumference (WC), high body mass index (BMI), high systolic blood pressure (SBP), increased levels of low-density lipoprotein, high blood glucose levels, low levels of physical activity and poor cardiorespiratory fitness. [2] However, screening for these conventional risk factors may underestimate the risk of CVD, especially in asymptomatic children. [3] Therefore, other non-conventional risk factors may be important to consider. Pulse wave velocity can be used as an indicator of arterial stiffness, which suggests structural changes in arterial walls that precede the events of atherosclerosis and CVD. [4] Arterial stiffness has been reported to be a notable risk factor for developing future CVD independent of conventional risk factors in adults. [4] Similarly, arterial stiffness has been shown to be positively associated with several conventional risk factors for CVD in children, [5] although findings in paediatric studies are inconsistent.Reed et al. [6] determined the predictors of arterial stiffness in a sample of 99 Canadian children (aged 9 -11 years). The results showed that children in the highest fitness quartile had 34% greater arterial compliance than children in the lower quartiles. Other predictors of arterial stiffness included body mass, SBP and maturation, [6] in accordance with a US population-based study that found significant associations between arterial stiffness, age, gender, BMI and SBP among 343 healthy adolescents and young adults (aged 15 -28 years). [7] Conflicting results were reported in a European study, which found no significant correlations between arterial stiffness, gender, age, BMI, Tanner stage or SBP levels among 38 non-obese adolescents (mean age and associated standard deviation (SD): 15.02 (1.94) years). [8] The same study reported a significant association between arterial stiffness and SBP among 68 obese adolescents (mean (SD) age: 13.27 (2.31) years). [8] This could imply that early vascular damage is more apparent in obese adolescents than in their lean counterparts.A greater understanding of arterial stiffness and its association with conventional CVD risk factors is warranted. Furthermore, it has been reported that black South African (SA) children are at an increased risk of developing CVD. [9] Similarly, increased arterial stiffness has been reported in black SA boys (aged 6 -8 years) compared with their white counterparts. [10] Thus, this study aimed to explore associations between specific conventional CVD risk factors and arterial stiffness in black SA children. Methods ParticipantsThis cross-sectional study recruited 59 black SA children (17 male, 42 female) from an urban primary school in the province of KwaZulu-Natal, SA, in ...

Physical Activity and cardiovascular function in 9-year-old schoolchildren: implications for health and well-being

“…In general, the functional capabilities of the cardiovascular system of 9-year-old students correspond to the average level (3 points) according to both the Robinson and Ruffier indices. These results are consistent with the findings of previous studies [3,8,30,31,32] that have shown that the functional capabilities of the cardiovascular system of children are generally at an average level.…”

“…Extensive research has established that physical activity not only enhances cardiovascular function but also reduces the risk of cardiovascular diseases later in life [1,2,3]. Studies have demonstrated that regular physical activity can improve cardiovascular function, mitigate the risk of cardiovascular disease, and contribute to overall health and well-being in children [4,5].…”

An Overview of Vascular Dysfunction and Determinants: The Case of Children of African Ancestry

“…However, very few studies assess the vascular function of children of African ancestry. A study in Kwa-Zulu Natal Province of South Africa shows that age and resting heart rate were positively associated with arterial stiffness among children aged 10-13 years old (149). Age could play an important role when assessing arterial stiffness (150).…”

“…However, for a deeper understanding, it should be examined in conjunction with growth and maturation, given that body height at the transition from childhood to adolescence is documented to affect arterial stiffness. An association between resting heart rate and arterial stiffness in children is still lacking in the literature (149). A study conducted in the Eastern Cape Province, South Africa, among 6-to 9-year-old children finds that blood pressure parameters, such as mean arterial and diastolic blood pressure, increased with increasing PWV (151).…”