Synergistic Effects of Elevated Systolic Blood Pressure and Hypercholesterolemia on Carotid Intima–Media Thickness in Children and Adolescents

Abstract

This study aimed to investigate the synergistic effects of elevated systolic blood pressure (SBP) and hypercholesterolemia on carotid intima-media thickness (cIMT). For this study, 60 children with hypercholesterolemia and 40 healthy control children were divided into four subgroups: hypercholesterolemic children with normal (<90th percentile) or elevated (>or= 90th percentile) SBP and control children with normal or elevated SBP. The highest mean and maximal cIMT values were found in the hypercholesterolemic children with elevated SBP and were significantly different from those of all the other groups. The synergistic effects of elevated SBP and hypercholesterolemia lead to a significant increase in cIMT as a subclinical sign of early atherosclerosis.

The effect of cardiovascular risk factors on the longitudinal evolution of the carotid intima medial thickness in children with type 1 diabetes mellitus

“…This is in accordance with other studies on weight and BMI development in children and adolescents with diabetes type 1 [23]. The BMI as mentioned above played a major role in cIMT development.…”

“…Even more impressive was the influence of the BMI z-score at first measurement, increasing the risk to develop a major augmentation in cIMT z-scores by the factor 3.02. As resulting from the literature, the association of several cardiovascular risk factors seems to add deleterious effects to the vascular bed in diabetic children [23]. Recently, also postprandial glucose levels have been found to be correlated to cIMT [24].…”

Increased carotid intima-media thickness in Brazilian adolescents with type 1 diabetes mellitus

“…Other risk factors such as dyslipidemia are well established in the physiopathological mechanism of atherosclerosis and associated to increased CIMT in patients with DM1 [29, 33] as we were able to show. In the diabetes control and complications trial/epidemiology of diabetes interventions and Complications study, LDL-C levels, formation of immune complexes, oxidized LDL levels, and final products of enzymatic glycosylation of LDL were significantly associated with the progression of CIMT [34].…”

“…A strong association has been reported between increased CIMT in patients with DM1 and high SBP, stronger than that with LDL-C levels, family history of CVD, and diabetes duration [29, 30]. It had been suggested that among metabolic syndrome components, SBP is one of the most significant factors associated with increased CIMT [30, 31].…”

Rheumatic Diseases and Endothelial Function

“…В обзоре Американской ассоциации сердца (American Heart Association, AHA), одобренной Американской ака-демией педиатрии [22], подчеркивается, что наличие традиционных факторов риска атеросклероза в сочета-нии с хроническими воспалительными заболеваниями ассоциируется с ускоренным развитием атеросклероза и появлением клинических коронарных событий в дет-ском или молодом возрасте. Длительные популяционные исследования с использованием неинвазивных методов оценки функции эндотелия подтвердили связь структурных и функциональных изменений сосудов у детей и подрост-ков с клинически значимыми сердечно-сосудистыми забо-леваниями в последующие возрастные периоды [79][80][81].…”