Περίληψη:
Arterial stiffness, assessed by carotid-femoral pulse wave velocity
(PWV) or indirectly by pulse pressure (PP) or ambulatory arterial
stiffness index (AASI), is an independent predictor of cardiovascular
disease in adults. However, in children limited evidence is available.
This study investigated the usefulness of AASI and PP as indices of
arterial stiffness in children and adolescents, by taking PWV as the
reference method. Eighty-two children and adolescents (mean age 13.1 +/-
2.9 years) had 24-h ambulatory blood pressure (ABP) monitoring, PWV
measurement and echocardiography. Compared with normotensives, subjects
with hypertension (n=16) had higher 24-h ABP, 24-h PP and PWV, but not
AASI. 24-h, PP was strongly correlated with age, weight, height, 24-h
systolic ABP, PWV, left ventricular mass (LVM), LVM index, stroke volume
and inversely with 24-h heart rate. AASI was also correlated with
weight, height, systolic ABP and LVM, yet these associations were weaker
than those of PP, and no significant correlations were found with PWV or
LVM index. Moreover, closer agreement of PWV was observed with 24-h PP
(71%, kappa 0.21) than with 24-h AASI (61%, kappa -0.06) in detecting
subjects at the top quartile of the respective distributions. In
children and adolescents, 24-h PP compared with AASI appears to be more
closely associated with: (i) arterial stiffness assessed by PWV; (ii)
target organ damage assessed by LVM index; and (iii) the presence of
essential hypertension. These data suggest that the usefulness of AASI
as an index of arterial stiffness in the pediatric population is
questionable. Hypertension Research (2010) 33, 1272-1277; doi:
10.1038/hr.2010.178; published online 30 September 2010
Συγγραφείς:
Stergiou, George S.
Kollias, Anastasios
Giovas, Periklis P. and
Papagiannis, John
Roussias, Leonidas G.
