J Hypertens. 2022 Jun 1;40(Suppl 1):e23. doi: 10.1097/01.hjh.0000835488.45395.d3.
OBJECTIVE: Functional characteristics of the vascular system underly changes associated with aging, such as increasing arterial stiffness. Research suggests that these age-associated changes may be accelerated in the presence of cardiovascular risk factors. So far, normative data on arterial stiffness in unselected adolescents and young adults have been scarce. Recently, measurements of carotid stiffness (cS) parameters have been included in a national health examination survey.
DESIGN AND METHOD: The population-based KiGGS cohort 11-year-follow-up included high-resolution B-mode sonography with semi-automated edge-detection and automatic electrocardiogram-gated real-time quality control. In 4,305 participants aged 14-28 years, distensibility coefficient (DC), stiffness index ß, Young’s (YEM) and Peterson’s elastic modulus (Ep) were assessed. Centiles were modelled by sex, age and height simultaneously, using generalized additive models for location, scale and shape. Log- binomial regression models were used to investigate associations of blood pressure with cS > = 90th centile (P90) as outcomes. Hypertensive blood pressure was defined according to German guidelines (> = P95 systolic or diastolic for age, height and sex according to KiGGS centiles until age 17 and > = 140/90 mmHg from age 18).
RESULTS: Multivariable models show that hypertensive blood pressure in childhood is associated with an increased risk of elevated cS (> = P90 for age, height and sex) eleven years later for all parameters of cS, with the exception of stiffness indexß (no association). Effect estimates for DC, YEM and Ep range from 1.77 [CI 1.28-2.44] for DC to 1.41 [CI 0.99-2.01] for YEM. Cross-sectional associations of blood pressure with cS parameters show even stronger associations (relative risks between 1.3 and 3.3).
CONCLUSIONS: Using state-of-the-art sonography and centiles computed with novel statistical methods, this study confirms that, at the population level, hypertensive blood pressure in childhood is linked to increased carotid stiffness in young adulthood. The results emphasize that healthy lifestyles and healthy living environments in childhood and adolescence represent an early investment in cardiovascular health.