Measurement of Central Aortic Blood Pressure in Youth: Role of Obesity and Sex

Harbin, Michelle M.; Hultgren, Neil E; Kelly, Aaron S.; Dengel, Donald R.; Evanoff, Nicholas G.; Ryder, Justin R.

doi:10.1093/ajh/hpy128

Cited by 15 publications

(10 citation statements)

References 40 publications

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“…Weight is a significant predictor of PWV ( p < 0.0001), SBP ( p < 0.0001), cSBP ( p < 0.0001), cDBP ( p < 0.0001) and cPP (p = 0.0117). However, central BP values are not well-validated with regard to normal ranges in children, and questions are raised with regard to the possibility of tonometry and oscillometry underestimating central BP [ 40 , 41 ], thus making the use of these methods of measurement questionable with regard to their clinical use. Our results, nevertheless, show strong positive correlations between central BP values and BMI, which suggests that even if the values are underestimated, adipose tissue still has an impact on central BP.…”

Section: Discussionmentioning

confidence: 99%

The Oscillometric Pulse Wave Analysis Is Useful in Evaluating the Arterial Stiffness of Obese Children with Relevant Cardiometabolic Risks

Mihuta

Paul

Borlea

et al. 2022

JCM

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Early detection of all complications of childhood obesity is imperative in order to minimize effects. Obesity causes vascular disruptions, including early increased arterial stiffness and high blood pressure. This study’s aim is to assess the reliability of pulse wave analysis (PWA) in obese children and how additional risk factors influence the evaluated parameters. We analyzed 55 children aged 6–18 years old by measuring their pulse wave velocity (PWV), augmentation index (AIx), peripheral blood pressure (SBP, DBP), heart rate, central blood pressure (cSBP, cDBP) and central pulse pressure (cPP). We used the oscillometric IEM Mobil-O-Graph and performed a single-point brachial measurement. The subjects were divided into two groups: obese (n = 30) and normal-weight (n = 25) and were clinically and anamnestically assessed. BMI and waist circumference are significantly correlated to higher values for PWV, SBP, DBP, cSBP, and cDBP. Weight significantly predicts PWV, SBP, DBP and cPP. The risk factors that significantly influence the PWA and BP values are: a cardiometabolically risky pregnancy (higher PWV, AIx, SBP), active and passive smoking (higher PWV, SBP, cSBP, cDBP), sleep deprivation (higher PWV, SBP, cSBP) and sedentariness (higher PWV, AIx, peripheral and central BP). We conclude that obese children with specific additional cardiometabolic risk factors present increased arterial stiffness and higher blood pressure values.

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Section: Discussionmentioning

confidence: 99%

The Oscillometric Pulse Wave Analysis Is Useful in Evaluating the Arterial Stiffness of Obese Children with Relevant Cardiometabolic Risks

Mihuta

Paul

Borlea

et al. 2022

JCM

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“…Moreover, both weight and height are significantly correlated to most PWA parameters; hence we can affirm that the correlations between the BMI and the PWA parameters are accurate. Some studies suggest that central BP values acquired through tonometry and oscillometry devices may be underestimated [55,56]; however, normal ranges of the central BP values in children are not entirely supported. This study showed a strong positive link between the BMI and cSBP, and cDBP, respectively, meaning that excess weight is associated with higher central BP values.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the Arterial Stiffness as a Useful Tool in the Management of Obese Children

et al. 2023

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Childhood obesity speeds up the development of arterial stiffness and progressively increases the values of arterial pressure. The purpose of this study is to investigate the value of using pulse wave analysis (PWA) to measure arterial stiffness as a sign of vascular wall impairment in obese children. The research was focused on 60 subjects: 33 obese and 27 normal-weight. Ages ranged from 6 to 18 years old. PWA includes parameters such as pulse wave velocity (PWV), augmentation index (AIx), peripheral and central blood pressure (SBP, DBP, cSBP, cDBP), heart rate, and central pulse pressure (cPP). The device used was a Mobil-O-Graph. Blood parameters were taken from the subject’s medical history, not older than 6 months. A high BMI and a large waist circumference are linked to a high PWV. The levels of LDL-c, triglycerides (TG), non-HDL-c, TG/HDL-c ratio, and total cholesterol-HDL-c ratio significantly correlate to PWV, SBP, and cSBP. Alanine aminotransferase is a reliable predictor of PWV, AIx, SBP, DBP, and cDBP, while aspartate aminotransferase is a significant predictor of AIx, mean arterial pressure (MAP), cSBP, and cPP. 25-OH-Vitamin D negatively correlates with PWV, SBP, and MAP and significantly predicts the MAP. Cortisol and TSH levels are not significant to arterial stiffness in obese children without specific comorbidities and neither is fasting glucose in obese children without impaired glucose tolerance. We conclude that PWA contributes valuable data regarding patients’ vascular health and should be considered a reliable tool in the management of obese children.

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“…Our finding that microparticles and EMPs levels are higher in youth with higher adiposity level is congruent with many other biomarkers of CVD risk, including other markers of subclinical endothelial dysfunction. 14 , 27 , 28 , 29 , 30 There are a number of reasons for the underlying association between adiposity and microparticle/EMP levels, including higher inflammation, dysregulated coagulation, and the independent role obesity may have on nitric oxide availability through a cascade of events. 10 , 31 , 32 , 33 However, this study does not provide the evidence for a causal link, and the underlying cause requires further investigation.…”

Section: Discussionmentioning

confidence: 99%

Relationship of Endothelial Microparticles to Obesity and Cardiovascular Disease Risk in Children and Adolescents

Jang

Palzer

Rudser

et al. 2022

JAHA

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Background Microparticles and endothelial microparticles (EMPs) are implicated in accelerating cardiovascular disease (CVD); however, data in pediatrics are limited. We examined the relationship of microparticles and EMPs with adiposity and subclinical CVD risk measures in a pediatric population to determine their potential as biomarkers of CVD risk. Methods and Results A cross‐sectional study of youth (n=280; ages 8–20 years) with a range of body mass index categories was used. Microparticles, EMPs, and activated EMPs were measured by flow cytometry. %Body fat and %visceral adipose tissue were measured by dual X‐ray absorptiometry. Measures of arterial stiffness and vascular wall structure were obtained. Linear regression (with log‐transformed outcomes) and logistic regression were used to evaluate associations and all results were exponentiated. Youth with overweight/obesity and severe obesity had 2.50 (95% CI, 1.56–4.01) and 3.42 (95% CI, 2.15–5.43) times the geometric means of the total number of microparticles, respectively, compared with those with normal weight. Youth with overweight/obesity and severe obesity had 1.97 (95% CI, 1.09–3.55) and 2.34 (95% CI, 1.31–4.19) times the geometric means of the total number of EMPs, respectively, compared with those with normal weight. There were positive associations between the levels of both microparticles and EMPs with higher adiposity measures and poor CVD risk measures. Youth with higher adiposity showed 1.84 times the odds of having high levels of activated EMPs (%) (odds ratio, 1.84; 95% CI, 1.08–3.14) compared with those with normal weight. Conclusions Levels of microparticles, EMPs, and activated EMPs were positively associated with adiposity and poor subclinical CVD risk in a pediatric population.

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Measurement of Central Aortic Blood Pressure in Youth: Role of Obesity and Sex

Abstract: In a cohort of youth with a wide range of adiposity levels, central aortic BP was elevated among individuals with SO and associated with BMI but not body fatness.

Cited by 15 publications

References 40 publications

The Oscillometric Pulse Wave Analysis Is Useful in Evaluating the Arterial Stiffness of Obese Children with Relevant Cardiometabolic Risks

The Oscillometric Pulse Wave Analysis Is Useful in Evaluating the Arterial Stiffness of Obese Children with Relevant Cardiometabolic Risks

Evaluating the Arterial Stiffness as a Useful Tool in the Management of Obese Children

Relationship of Endothelial Microparticles to Obesity and Cardiovascular Disease Risk in Children and Adolescents

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