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 (≥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.
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Bachorik PS, Ross JW (1995) National cholesterol education program recommendations for measurement of low-density lipoprotein cholesterol: executive summary. Clin Chem 41:1414–1420
Berenson GS, Srinivasan SR, Bao W, Newman WP III, Tracy RE, Wattigney WA (1998) Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. N Engl J Med 338:1650–1656
Bonetti PO, Lerman OL, Lerman A (2003) Endothelial dysfunction: a marker of atherosclerotic risk. Arterioscler Thromb Vasc Biol 23:168–175
Cheng D, Schmidt-Trucksäss A, Cheng K, Burkhardt H (2002) Using snakes to detect the intimal and adventitial layers of the common carotid artery wall in sonography images. Comput Methods Programs Biomed 67:27–37
Dalla Pozza R, Bechtold S, Bonfig W, Putzker S, Kozlik-Feldmann R, Netz H, Schwarz HP (2007) Age of onset of type 1 diabetes in children and carotid intima medial thickness. J Clin Endocrinol Metab 92:2053–2057
Daniels SR, Greer FR, The Committee on Nutrition (2008) Lipid screening and cardiovascular health in childhood. Pediatrics 122:198–208
Félétou M, Vanhoutte PM (2006) Endothelial dysfunction: a multifaceted disorder. Am J Physiol Heart Circ Physiol 291:H985–H1002
Groner JA, Joshi M, Bauer JA (2006) Pediatric precursors of adult cardiovascular disease: noninvasive assessment of early vascular changes in children and adolescents. Pediatrics 118:1683–1691
Halcox JPJ, Deanfield JE (2005) Childhood origins of endothelial dysfunction. Heart 91:1272–1274
Hansen ML, Gunn PW, Kaelber DC (2007) Underdiagnosis of hypertension in children and adolescents. JAMA 298:874–879
Jago R, Harrell JS, McMurray RG, Edelstein S, El Ghormli L, Bassin S (2006) Prevalence of abnormal lipid and blood pressure values among an ethnically diverse population of eighth-grade adolescents and screening implications. Pediatrics 117:2065–2073
Järvisalo MJ, Jartti L, Näntö-Salonen K, Irjala K, Rönnemaa T, Hartiala JJ, Celermajer DS, Raitakari OT (2001) Increased aortic intima–media thickness: a marker of preclinical atherosclerosis in high-risk children. Circulation 104:2943–2947
Järvisalo MJ, Lehtimäki T, Raitakari OT (2004) Determinants of arterial nitrate-mediated dilatation in children. Circulation 109:2885–2889
Kromeyer-Hauschild K, Wabitsch M, Kunze D, Geller F, Geiss HC, Hesse V, von Hippel A, Jaeger U, Johnsen D, Korte W, Menner K, Müller G, Müller JM, Niemann-Pilatus A, Remer T, Schaefer F, Wittchen HU, Zabransky S, Zellner K, Ziegler A, Hebebrand J (2001) Perzentile für den Body-Mass-Index für das Kindes- und Jugendalter unter Heranziehung verschiedener deutscher Stichproben. Monatsschr Kinderheilkd 149:807–818
Lakka TA, Salonen R, Kaplan GA, Salonen JT (1999) Blood pressure and the progression of carotid atherosclerosis in middle-aged men. Hypertension 34:51–54
Lande MB, Carson NL, Roy J, Meagher CC (2006) Effects of childhood primary hypertension on carotid intima–media thickness. Hypertension 48:40–44
Li S, Chen W, Srinivasan SR, Bond MG, Tang R, Urbina EM, Berenson GS (2003) Childhood cardiovascular risk factors and carotid vascular changes in adulthood. JAMA 290:2271–2276
Litwin M, Trelewicz J, Wawer Z, Antoniewicz J, Wierzbicka A, Rajszys P, Grenda R (2004) Intima–media thickness and arterial elasticity in hypertensive children: controlled study. Pediatr Nephrol 19:767–774
McGill HC, McMahan CA, Herderick EE, Malcolm GT, Tracy RE, Strong JP (2000) Origin of atherosclerosis in childhood and adolescence. Am J Clin Nutr 72(Suppl):1307S–1315S
McMahan CA, Gidding SS, Malcolm GT, Tracy RE, Strong JP, McGill HC (2006) Pathobiological determinants of atherosclerosis in youth risk scores are associated with early and advanced atherosclerosis. Pediatrics 118:1447–1455
McNiece KL, Poffenbarger TS, Turner JL, Franco KD, Sorof JN, Portman RJ (2007) Prevalence of hypertension and prehypertension among adolescents. J Pediatr 150:640–644
National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents (2004) The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 114(Suppl):555–576
O’Leary DH, Polak JF, Kronmal RA, Manolio TA, Burke GL, Wolfson SK Jr (1999) Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. N Engl J Med 340:14–22
Pall D, Settakis G, Katona E, Csiba L, Kakuk G, Limburg M, Bereczki D, Fülesdi B (2003) Increased common carotid artery intima–media thickness in adolescent hypertension. Cerebrovasc Dis 15:167–172
Paradis G, Lambert M, O’Loughlin J, Lavallee C, Aubin J, Delvin E, Levy E, Hanley JA (2004) Blood pressure and adiposity in children and adolescents. Circulation 110:1832–1838
Raitakari OT, Juonala M, Kähönen M, Taittonen L, Laitinen T, Mäki-Torkko N, Järvisalo MJ, Uhari M, Jokinen E, Rönnemaa T, Akerblom HK, Viikari JSA (2003) Cardiovascular risk factors in childhood and carotid artery intima–media thickness in adulthood. JAMA 290:2277–2283
Reinehr T, Kiess W, de Sousa G, Stoffel-Wagner B, Wunsch R (2006) Intima–media thickness in childhood obesity: relations to inflammatory marker, glucose metabolism, and blood pressure. Metabolism 55:113–118
Rodriguez-Porcel M, Lerman LO, Herrmann J, Sawamura T, Napoli C, Lerman A (2003) Hypercholesterolemia and hypertension have synergistic deleterious effects on coronary endothelial function. Arterioscler Thromb Vasc Biol 23:885–891
Rodriguez-Porcel M, Lerman A, Herrmann J, Schwartz RS, Sawamura T, Condorelli M, Napoli C, Lerman LO (2003) Hypertension exacerbates the effect of hypercholesterolemia on the myocardial microvasculature. Cardiovasc Res 58:213–221
Sass C, Herbeth B, Chapet O, Siest G, Visvikis S, Zannad F (1998) Intima–media thickness and diameter of carotid and femoral arteries in children, adolescents, and adults from the Stanislas cohort: effect of age, sex, anthropometry, and blood pressure. J Hypertens 16:1593–1602
Schmidt-Trucksäss A, Cheng D, Sandrock M, Schulte-Mönting J, Rauramaa R, Huonker M, Burkhardt H (2001) Computerized analysing system using the active contour in ultrasound measurement of carotid artery intima–media thickness. Clin Physiol 21:561–569
Schwab KO, Doerfer J, Krebs A, Krebs K, Schorb E, Hallermann K, Superti-Furga A, Zieger B, März W, Schmidt-Trucksäss A, Winkler K (2007) Early atherosclerosis in childhood type 1 diabetes: role of raised systolic blood pressure in the absence of dyslipidaemia. Eur J Pediatr 166:541–548
Schwab KO, Doerfer J, Hecker W, Grulich-Henn J, Wiemann D, Kordonouri O, Beyer P, Holl RW (2006) Spectrum and prevalence of atherogenic risk factors in 27, 358 children, adolescents, and young adults with type 1 diabetes: cross-sectional data from the German diabetes documentation and quality management system (DPV). Diabetes Care 29:218–225
Sorof JM, Alexandrov AV, Garami Z, Turner JL, Grafe RE, Lai D, Portman RJ (2003) Carotid ultrasonography for detection of vascular abnormalities in hypertensive children. Pediatr Nephrol 18:1020–1024
Sorof JM, Cardwell G, Franco K, Portman RJ (2002) Ambulatory blood pressure and left ventricular mass index in hypertensive children. Hypertension 39:903–908
Sun N, Wood NB, Hughes AD, Thom SAM, Xu XY (2007) Effects of transmural pressure and wall shear stress on LDL accumulation in the arterial wall: a numerical study using a multilayered model. Am J Physiol Heart Circ Physiol 292:H3148–H3157
Toikka JO, Laine H, Ahotupa M, Haapanen A, Viikari JSA, Hartiala JJ, Raitakari OT (2000) Increased arterial intima–media thickness and in vivo LDL oxidation in young men with borderline hypertension. Hypertension 36:929–933
Virkola K, Pesonen E, Akerblom HK, Siimes MA (1997) Cholesterol and carotid wall in children and adolescents with familial hypercholesterolaemia: a controlled study by ultrasound. Acta Paediatr 86:1203–1207
Wiegman A, de Groot E, Hutten BA, Rodenburg J, Gort J, Bakker HD, Sijbrands EJG, Kastelein JJP (2004) Arterial intima–media thickness in children heterozygous for familial hypercholesterolaemia. Lancet 363:369–370
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Krebs, A., Schmidt-Trucksäss, A., Alt, J. et al. Synergistic Effects of Elevated Systolic Blood Pressure and Hypercholesterolemia on Carotid Intima–Media Thickness in Children and Adolescents. Pediatr Cardiol 30, 1131–1136 (2009). https://doi.org/10.1007/s00246-009-9510-6
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DOI: https://doi.org/10.1007/s00246-009-9510-6