Obese children show increased intimal wall thickness and decreased pulse wave velocity

Dangardt, Frida; Osika, Walter; Volkmann, Reinhard; Gan, Li‐Ming; Friberg, Peter

doi:10.1111/j.1475-097x.2008.00806.x

Cited by 97 publications

(103 citation statements)

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“…The negative association between obesity and vascular stiffness observed in children 16 and adolescents 14,15 and the positive association reported in older adults and the elderly [7][8][9]12 are consistent with our findings across the adult age span and support the hypothesis that during adulthood, the physiological relationship between obesity and vascular function alters. We also observed that both high body fat and reduced lean mass were associated with lower PWV in younger adults.…”

Section: Discussionsupporting

confidence: 81%

“…In older adults, there are data that indicate increasing arterial stiffness with obesity, [7][8][9] although findings have been inconsistent across studies. [10][11][12][13] In contrast, obese children have reduced arterial stiffness compared with their normal weight peers, [14][15][16] an effect thought to result from physiological adaptation to the hyperemic state of obesity in the young. 16 Taken together these contrasting data from young and old populations suggest age-related differences in the relationship between body composition and arterial stiffness, which have not been fully explored.…”

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confidence: 99%

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Body Fat Is Associated With Reduced Aortic Stiffness Until Middle Age

et al. 2013

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Abstract-Obesity is a major risk factor for cardiometabolic disease, but the effect of body composition on vascular aging and arterial stiffness remains uncertain. We investigated relationships among body composition, blood pressure, age, and aortic pulse wave velocity in healthy individuals. Pulse wave velocity in the thoracic aorta, an indicator of central arterial stiffness, was measured in 221 volunteers (range, 18-72 years; mean, 40.3±13 years) who had no history of cardiovascular disease using cardiovascular MRI. In univariate analyses, age (r=0.78; P<0.001) and blood pressure (r=0.41; P<0.001) showed a strong positive association with pulse wave velocity. In multivariate analysis, after adjustment for age, sex, and mean arterial blood pressure, elevated body fat% was associated with reduced aortic stiffness until the age of 50 years, thereafter adiposity had an increasingly positive association with aortic stiffness (β=0.16; P<0.001). Body fat% was positively associated with cardiac output when age, sex, height, and absolute lean mass were adjusted for (β=0.23; P=0.002). These findings suggest that the cardiovascular system of young adults may be capable of adapting to the state of obesity and that an adverse association between body fat and aortic stiffness is only apparent in later life. (Hypertension. 2013;61:1322-1327.)

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Section: Discussionsupporting

confidence: 81%

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confidence: 99%

Body Fat Is Associated With Reduced Aortic Stiffness Until Middle Age

et al. 2013

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“…In adults, a positive relationship between obesity and PWV has been described in cross-sectional studies, 22,23 and a reduction in PWV was observed after losing weight, 24 although these studies had not considered the impact of BP values at the same time. Controversial results exist in the childhood population 14,25,26 that may be partially explained by differences in patient populations (age, sex, and small sample size) and heterogeneity of the techniques used. In our study, the vascular phenotype assessment was performed in a large number of nonobese and obese subjects by the same operators with homogeneous methodology in only 1 center.…”

Section: Discussionmentioning

confidence: 99%

“…These alterations are manifested not only in high peripheral or central BP 11 but also in reflecting waves 12,13 and in pulse wave velocity (PWV). 14 These intermediate phenotypes, as an expression of functional or structural abnormalities in the vascular tree, can be the cause, as well as the consequence, of early vascular alterations. Vascular phenotypes of large vessels provide a novel viewpoint for studying functional abnormalities, and because it can be clinically relevant, it represents a field of growing interest.…”

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confidence: 99%

Blood Pressure and Obesity Exert Independent Influences on Pulse Wave Velocity in Youth

et al. 2012

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Abstract-The objective was to analyze pulse wave velocity (PWV) in normotensive, high-normal, and hypertensive youths by using aortic-derived parameters from peripheral recordings. The impact of obesity on vascular phenotypes was also analyzed. A total of 501 whites from 8 to 18 years of age were included. The subjects were divided according to BP criteria: 424 (85%) were normotensive, 56 (11%) high-normal, and 21 (4%) hypertensive. Obesity was present in 284 (56%) and overweight in 138 (28%). Pulse wave analysis using a SphygmoCor device was performed to determine central blood pressure (BP), augmentation index, and measurement of PWV. Among the BP groups, differences appeared in age, sex, and height but not in body mass index. Significant differences in peripheral and central systolic and diastolic BPs and pulse pressures were observed within groups. A graded increase in PWV was present across the BP strata without differences in augmentation index. Using a multiple regression analysis, age, BP groups, and obesity status were independently associated with PWV. Older and hypertensive subjects had the highest PWV, whereas, from normal weight status to obesity, PWV decreased. Likewise, PWV was positively related to peripheral or central systolic BP and negatively related to body mass index z score. For 1 SD of peripheral systolic BP, PWV increased 0.329 m/s, and for 1 SD of body mass index z score PWV decreased 0.129 m/s. In conclusion, PWV is increased in hypertensive and even in high-normal children and adolescents. Furthermore, obesity, the factor most frequently related to essential hypertension in adolescents, blunted the expected increment in PWV of hypertensive and high-normal subjects. (Hypertension. 2012;60:550-555.)Key Words: hypertension Ⅲ obesity Ⅲ children Ⅲ adolescents Ⅲ augmentation index Ⅲ pulse wave velocity C ardiovascular damage occurring in adults finds its roots in risk factors operating early in life. Among the factors influencing cardiovascular risk, blood pressure (BP) values represent an important measurable marker of the level of potential cardiovascular risk in children and adolescents. The need to identify cardiovascular risk factors, including high BP, in youth, is acknowledged more and more frequently. Consequently, measurement of BP has become a routine part of pediatric care, and asymptomatic hypertension is now detected in pediatric care practice.BP phenotype is determined not only by conventional risk factors but also by weight gain in childhood. The adverse effects of excessive weight gain on BP and the association of weight gain with higher incidence of BP elevation represent major issues in health care.1-5 Elevation of systolic and/or diastolic BP indicates high BP in the child. In addition, children and adolescents with mild BP elevation, in the high-normal range, are much more common than was thought in the past, ranging from 3.4% to 15.7%. 6,7 Rather than having a goal of classifying children as high-normal, we should be identifying those who may be at risk for the developm...

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“…The intra-individual variation (the coefficient of variation of repeated measurements by the same operator) was 8.1% for the IT and 4.0% for IMT of the radial artery and 1.5% for the diameter of the radial artery. 14 …”

Section: Ultrasound Measurementsmentioning

confidence: 99%

Increased intima thickness of the radial artery in patients with coronary heart disease

et al. 2009

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Ultrabiomicroscopy is a novel high-frequency (55 MHz) ultrasound technique that could be used to non-invasively measure the vessel wall and separate the intima-media complex into measurements of intima and media thickness. Since no previous study has measured intima and media thickness separately in vivo in patients with coronary heart disease (CHD), the aim of the current study was to measure intima and intima-media thickness of the radial and the anterior tibial arteries among patients with CHD and healthy subjects (HS). Thirty-two patients with CHD and 46 HS underwent investigations with ultrabiomicroscopy measurements of the radial and anterior tibial arteries. Patients with CHD showed a 19% increase in intima thickness of the radial artery compared with HS (0.088  0.024 mm versus 0.074  0.015 mm; p < 0.015), whereas no difference was seen in media thickness. There were no differences in intima or media thickness within the anterior tibial arteries. In conclusion, CHD is associated with thickening of the intima of the radial artery whereas media thickness was unchanged compared with HS. Assessment of intima thickness by highfrequency ultrasound may provide a tool for non-invasive early detection of atherosclerosis.

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Obese children show increased intimal wall thickness and decreased pulse wave velocity

Abstract: Obese children and adolescents, primarily females, present with increased RA IT. The decreased PWV in the obese versus lean subjects might reflect general vasodilatation.

Cited by 97 publications

References 43 publications

Body Fat Is Associated With Reduced Aortic Stiffness Until Middle Age

Body Fat Is Associated With Reduced Aortic Stiffness Until Middle Age

Blood Pressure and Obesity Exert Independent Influences on Pulse Wave Velocity in Youth

Increased intima thickness of the radial artery in patients with coronary heart disease

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