Paradoxical Increase in Arterial Compliance in Obese Pubertal Children

Chalmers, Laura; Copeland, Kenneth C.; Hester, Casey N.; Fields, David A.; Gardner, Andrew W.

doi:10.1177/0003319711399117

Cited by 25 publications

(28 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In agreement with the present results, previous reports concluded that obesity was associated with a decreased PWV 14 and with high large vessel elasticity. 27,28 If obesity, as observed in our study, reduces the increment in PWV and, for instance, gave spurious data for 1 of the early hypertensioninduced organ damage markers, it would be a relevant clinical finding with long-lasting consequences. In fact, lower cardiovascular risk in obese subjects, as compared with lean subjects with the same BP elevation, has been described.…”

Section: Discussionmentioning

confidence: 66%

Blood Pressure and Obesity Exert Independent Influences on Pulse Wave Velocity in Youth

et al. 2012

View full text Add to dashboard Cite

Abstract-The objective was to analyze pulse wave velocity (PWV) in normotensive, high-normal, and hypertensive youths by using aortic-derived parameters from peripheral recordings. The impact of obesity on vascular phenotypes was also analyzed. A total of 501 whites from 8 to 18 years of age were included. The subjects were divided according to BP criteria: 424 (85%) were normotensive, 56 (11%) high-normal, and 21 (4%) hypertensive. Obesity was present in 284 (56%) and overweight in 138 (28%). Pulse wave analysis using a SphygmoCor device was performed to determine central blood pressure (BP), augmentation index, and measurement of PWV. Among the BP groups, differences appeared in age, sex, and height but not in body mass index. Significant differences in peripheral and central systolic and diastolic BPs and pulse pressures were observed within groups. A graded increase in PWV was present across the BP strata without differences in augmentation index. Using a multiple regression analysis, age, BP groups, and obesity status were independently associated with PWV. Older and hypertensive subjects had the highest PWV, whereas, from normal weight status to obesity, PWV decreased. Likewise, PWV was positively related to peripheral or central systolic BP and negatively related to body mass index z score. For 1 SD of peripheral systolic BP, PWV increased 0.329 m/s, and for 1 SD of body mass index z score PWV decreased 0.129 m/s. In conclusion, PWV is increased in hypertensive and even in high-normal children and adolescents. Furthermore, obesity, the factor most frequently related to essential hypertension in adolescents, blunted the expected increment in PWV of hypertensive and high-normal subjects. (Hypertension. 2012;60:550-555.)Key Words: hypertension Ⅲ obesity Ⅲ children Ⅲ adolescents Ⅲ augmentation index Ⅲ pulse wave velocity C ardiovascular damage occurring in adults finds its roots in risk factors operating early in life. Among the factors influencing cardiovascular risk, blood pressure (BP) values represent an important measurable marker of the level of potential cardiovascular risk in children and adolescents. The need to identify cardiovascular risk factors, including high BP, in youth, is acknowledged more and more frequently. Consequently, measurement of BP has become a routine part of pediatric care, and asymptomatic hypertension is now detected in pediatric care practice.BP phenotype is determined not only by conventional risk factors but also by weight gain in childhood. The adverse effects of excessive weight gain on BP and the association of weight gain with higher incidence of BP elevation represent major issues in health care.1-5 Elevation of systolic and/or diastolic BP indicates high BP in the child. In addition, children and adolescents with mild BP elevation, in the high-normal range, are much more common than was thought in the past, ranging from 3.4% to 15.7%. 6,7 Rather than having a goal of classifying children as high-normal, we should be identifying those who may be at risk for the developm...

show abstract

Section: Discussionmentioning

confidence: 66%

Blood Pressure and Obesity Exert Independent Influences on Pulse Wave Velocity in Youth

et al. 2012

View full text Add to dashboard Cite

show abstract

“…Two previous studies have shown a positive relationship between obesity and PWV in women only, 12,13 but we found no sex differences in the relationship between body composition and aortic stiffness. Corresponding age-dependent effects on vascular elastic function have also been observed, with obese children demonstrating higher arterial elasticity 38,39 and obese adults having impaired elasticity. 40,41 An association reported between carotid-femoral pulse wave velocity and HR 7,42 has been attributed to fatigue failure of elastin fibers; 43 however in common with another MRI study, we did not observe a relationship between HR and aortic PWV.…”

Section: Discussionmentioning

confidence: 80%

Body Fat Is Associated With Reduced Aortic Stiffness Until Middle Age

et al. 2013

View full text Add to dashboard Cite

Abstract-Obesity is a major risk factor for cardiometabolic disease, but the effect of body composition on vascular aging and arterial stiffness remains uncertain. We investigated relationships among body composition, blood pressure, age, and aortic pulse wave velocity in healthy individuals. Pulse wave velocity in the thoracic aorta, an indicator of central arterial stiffness, was measured in 221 volunteers (range, 18-72 years; mean, 40.3±13 years) who had no history of cardiovascular disease using cardiovascular MRI. In univariate analyses, age (r=0.78; P<0.001) and blood pressure (r=0.41; P<0.001) showed a strong positive association with pulse wave velocity. In multivariate analysis, after adjustment for age, sex, and mean arterial blood pressure, elevated body fat% was associated with reduced aortic stiffness until the age of 50 years, thereafter adiposity had an increasingly positive association with aortic stiffness (β=0.16; P<0.001). Body fat% was positively associated with cardiac output when age, sex, height, and absolute lean mass were adjusted for (β=0.23; P=0.002). These findings suggest that the cardiovascular system of young adults may be capable of adapting to the state of obesity and that an adverse association between body fat and aortic stiffness is only apparent in later life. (Hypertension. 2013;61:1322-1327.)

show abstract

“…However, data on arterial compliance in normal or obese children are conflicting; several studies have reported decreased arterial compliance in obese adoles- Insulin levels, μU/ml -3 2 ± 6 3 1 ± 5 HOMA-IR -5.9 ± 1.5 11.6 ± 7.6 ** p < 0.01 vs. lean; † p < 0.01 vs. obese. [15] who reported an increase in small arterial compliance in obese pubertal children using radial artery pulse wave contour analysis. Dangardt et al [16] also reported decreased pulse wave velocity at radial artery (and hence increased compliance) in obese adolescent girls compared to lean controls despite increased radial intimal thickness.…”

Section: Discussionmentioning

confidence: 99%

Vascular Compliance in Lean, Obese, and Diabetic Children and Adolescents: A Cross-Sectional Study in a Minority Population

et al. 2014

View full text Add to dashboard Cite

Background: In adults, both obesity and type 2 diabetes mellitus (T2DM) are positively correlated with cardiovascular disease mortality and arterial stiffness. Several studies of adults have shown that both obesity and T2DM are independently associated with increased arterial stiffness. However, little is known about the relationship between arterial compliance and cardiovascular disease risk in children. We assessed whether large and small arterial compliance is impaired in obese and diabetic pubertal children. Methods: One hundred children of African-Caribbean ethnicity, aged 14-16 years, including 21 lean children (between the 25th and 75th percentile), 40 obese children (>95th percentile), and 39 children with T2DM diagnosed by American Diabetes Association criteria were studied. Arterial compliance of the large (C 1 ) and small (C 2 ) vessels was measured using radial arterial diastolic pulse wave contour analysis. Results: C 1 did not differ significantly between lean, obese, and T2DM subjects. C 2 was significantly greater in obese and T2DM subjects (10.9 ± 1 and 10.4 ± 0.7 ml/mm Hg × 100 ml, respectively) compared to lean subjects (7.8 ± 0.8 ml/mm Hg × 100 ml; p < 0.05). C 2 was also significantly greater in T2DM subjects receiving antihypertensive drug therapy than in diabetic subjects not on antihypertensive treatment. Conclusion: Increased compliance in diabetic and obese children compared to lean subjects could be secondary to premature maturation of the vascular system; whether this early maturation can translate into a subsequent rise in the incidence of cardiovascular events related to diabetes and obesity can only be determined by long-term follow-up of these patients.

show abstract

Paradoxical Increase in Arterial Compliance in Obese Pubertal Children

Cited by 25 publications

References 47 publications

Blood Pressure and Obesity Exert Independent Influences on Pulse Wave Velocity in Youth

Blood Pressure and Obesity Exert Independent Influences on Pulse Wave Velocity in Youth

Body Fat Is Associated With Reduced Aortic Stiffness Until Middle Age

Vascular Compliance in Lean, Obese, and Diabetic Children and Adolescents: A Cross-Sectional Study in a Minority Population

Contact Info

Product

Resources

About