Children and Adolescent Obesity Associates with Pressure-Dependent and Age-Related Increase in Carotid and Femoral Arteries’ Stiffness and Not in Brachial Artery, Indicative of Nonintrinsic Arterial Wall Alteration

Abstract

Aim. To analyze if childhood obesity associates with changes in elastic, transitional, and/or muscular arteries' stiffness. Methods. 221 subjects (4–15 years, 92 females) were assigned to normal weight (NW, n = 137) or obesity (OB, n = 84) groups, considering their body mass index z-score. Age groups were defined: 4–8; 8–12; 12–15 years old. Carotid, femoral, and brachial artery local stiffness was determined through systodiastolic pressure-diameter and stress-strain relationships. To this end, arterial diameter and peripheral and aortic blood pressure (BP) levels and waveforms were recorded. Carotid-femoral, femoropedal, and carotid-radial pulse wave velocities were determined to evaluate aortic, lower-limb, and upper-limb regional arterial stiffness, respectively. Correlation analysis between stiffness parameters and BP was done. Results. Compared to NW, OB subjects showed higher peripheral and central BP and carotid and femoral stiffness, reaching statistical significance in subjects aged 12 and older. Arterial stiffness differences disappeared when levels were normalized for BP. There were no differences in intrinsic arterial wall stiffness (elastic modulus), BP stiffness relationships, and regional stiffness parameters. Conclusion. OB associates with BP-dependent and age-related increase in carotid and femoral (but not brachial) stiffness. Stiffness changes would not be explained by intrinsic arterial wall alterations but could be associated with the higher BP levels observed in obese children.

Raised body mass index and cardiovascular indices in secondary school students, South-South Nigeria

“…12 Other manifestation of arterial stiffness are elevated diastolic blood pressure (DBP) and increased mean arterial pressure (MAP). 8,9,[13][14][15][16] However, those who had these manifestations of arterial stiffness did not have raised BMI, probably because, as observed by Chandramohan et al, central obesity relates more to CV events than obesity defined by BMI calculation (that was used in this study). 24 Elevated SBP was associated with a comparably wider PP but wide PP was not associated with higher SBP.…”

“…[3][4][5][6][7] In children, raised BMI is complicated with the development of cardiovascular (CV) diseases. [8][9][10] Although risk increases with increased BMI, both obesity and overweight predispose to the same complications, hence the emphasis on raised BMI. 1 Arterial stiffness (AS) occurs in raised BMI and CV events are the consequences.…”

“…12 Other manifestation of arterial stiffness are elevated diastolic blood pressure (DBP) and increased mean arterial pressure (MAP). 8,9,[13][14][15][16] Systolic BP has always been the determinant of CV risk but recently PP has been shown to be the major determinant, and a rise in the prevalence of widened PP in children, as well as HTN have been noted in this era of childhood obesity. 4,6,14,16,17 Fortunately, raised BMI and likewise, it's complications are largely preventable.…”

“…The Junior secondary school student cohort is supposed to be in their early adolescence when AS due to obesity is likely to start developing, as this has been noted to start from adolescents (10 years) to old age. 9,13 Influencing their lifestyle at this age will be most beneficial. This study educated secondary school children on healthy lifestyle, screened the junior students for raised BMI, elevated SBP, DBP, MAP and PP.…”

Diastolic Augmentation Index Improves Augmentation Index in Assessing Arterial Stiffness

“…Arterial stiffness is an important risk factor for cardiovascular (CV) events and is increasingly used clinically [1][2][3][4]. Many indicators have been proposed for the assessment of arterial stiffness.…”