Racial Differences in Aortic Stiffness in Children

Abstract

Objective To investigate racial differences in central blood pressure and vascular structure/function as subclinical markers of atherosclerotic cardiovascular disease (CVD) in children. Study design This cross-sectional study recruited 54 African-American children (18 female, 36 male; age 10.5 ± 0.9) and 54 white children (27 female, 26 male; age 10.8 ± 0.9) from the Syracuse City community as part of the Environmental Exposures and Child Health Outcomes (EECHO) study. Participants underwent blood lipid and vascular testing on two separate days. Carotid artery intima-media thickness (IMT) and aortic stiffness were measured via ultrasonography and carotid-femoral pulse wave velocity (PWV), respectively. Blood pressure (BP) was assessed at the brachial artery and estimated in the carotid artery using applanation tonometry. Results African American children had significantly higher PWV (4.8 ± 0.8 m/s) compared with white children (4.2 ± 0.7 m/s; p<0.05) which remained significant after adjustment for confounding variables including socioeconomic status. African-American children had significantly higher IMT (African-American 0.41 ± 0.06, white 0.39 ± 0.05 mm), and carotid systolic BP (African-American 106 ± 11, white 102 ± 8 mmHg; p<0.05) compared with white children, although these racial differences were no longer present after covariate adjustments for height. Conclusions Racial differences in aortic stiffness are present in childhood. Our findings suggest that racial differences in subclinical CVD occur earlier than previously recognized.

Carotid artery stiffness and cerebral pulsatility in children

“…Detailed inclusion/exclusion criteria have been previously reported [5]. This study was approved by the institutional review board of Syracuse University and SUNY Upstate University.…”

Students of color show health advantages when they attend schools that emphasize the value of diversity

“…For example, relative to whites, African American and Latino adolescents are more likely to be overweight (21), which predicts greater risk for cardiovascular disease and other chronic diseases of aging later in life (22). Relative to white adolescents, African American adolescents also show more insulin resistance, which increases risk for subsequent diabetes, and more carotid artery intima-media thickness, a marker of preclinical atherosclerosis that portends higher risk for subsequent cardiovascular disease (23,24). By adulthood, there are notable racial disparities in cardiovascular disease prevalence and mortality, as well as in diabetes prevalence (19).…”

“…These racial disparities in health hold even when controlling for socioeconomic status (20,21,23,24), indicating that adolescents of Significance The United States is increasingly diverse, especially among youth. At the same time, racial and ethnic gaps persist in many domains, including risk for cardiovascular disease.…”

Racial Differences in Left Ventricular Mass and Wave Reflection Intensity in Children

“…Body mass index (BMI) was calculated as weight (kg)/height (m) 2 . Socioeconomic status (SES) was calculated as an average of parental occupation, income, and education data (z-scored prior to averaging) as we have previously described (24,30).…”

“…Increases in large artery stiffness and pressure from wave reflections alter ventricular-vascular coupling, contributing to increased afterload, myocardial strain, LVM, and ultimately LV hypertrophy (23). Racial differences in hemodynamic load may also have its origins in childhood as African American children have increased arterial stiffness compared to NHW children (24) and central BP is associated with LVM in young African American adolescents (25).…”