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Ambulatory hemodynamic patterns, obesity, and pulse wave velocity in children and adolescents

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Abstract

Background

In recent years, pulse wave velocity (PWV) has emerged as a surrogate marker of cardiovascular disease in children with cardiovascular risk factors. The aims of the present study were to identify determinants of PWV in children according to their weight status and to investigate the role of peripheral blood pressure and central hemodynamic parameters in the association between PWV and obesity.

Methods

We included in the study healthy children and adolescents randomly selected from a school-based blood pressure screening study. All participants underwent ambulatory blood pressure monitoring and 24-h pulse wave analysis.

Results

Overweight and obese children had higher 24-h PWV, 24-h peripheral and central systolic blood pressure (SBP), and cardiac output than normal weight ones. Children with both overweight and hypertension presented the highest 24-h PWV values (p < 0.001). Peripheral and central SBP, body mass index (BMI), and hemodynamic parameters, including stroke volume, cardiac output, total peripheral resistance, and cardiac index, were all associated with 24-h PWV. However, in stepwise regression analysis, 24-h peripheral and central SBP and cardiac index, but not BMI, were independent predictors of 24-h PWV. There were statistically significant differences in 24-h blood pressure and hemodynamic parameters among those on the lower and highest 24-h PWV quartile, but there were no significant differences in BMI among 24-h PWV quartile groups.

Conclusions

Arterial stiffness is higher in overweight and obese children in the co-presence of hypertension. Peripheral and central SBP are the main determinants of 24-h PWV independent of weight status.

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Authors and Affiliations

  1. 1st Department of Pediatrics, Pediatric Nephrology Unit, Hippokratio Hospital, Aristotle University of Thessaloniki, 49 Konstantinoupoleos Street, 54642, Thessaloniki, Greece

    Stella Stabouli & Katerina Chrysaidou

  2. 3rd Department of Pediatrics, Hippokratio Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Konstantinos Kollios & Thomaitsa Nika

  3. 4th Department of Pediatrics, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Despoina Tramma

  4. 3rd Department of Internal Medicine, Hypertension-24h ABPM Center, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Vasilios Kotsis

Authors
  1. Stella Stabouli
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  2. Konstantinos Kollios
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  3. Thomaitsa Nika
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  4. Katerina Chrysaidou
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  6. Vasilios Kotsis
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Correspondence to Stella Stabouli.

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This study was approved by the Greek Ministry of National Education, the National Educational Institute, and the Ethics Committee of the Aristotle University of Thessaloniki and was conducted in accordance with the 1964 Helsinki Declaration standards.

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Stabouli, S., Kollios, K., Nika, T. et al. Ambulatory hemodynamic patterns, obesity, and pulse wave velocity in children and adolescents. Pediatr Nephrol 35, 2335–2344 (2020). https://doi.org/10.1007/s00467-020-04694-1

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