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 ...