Ambulatory hemodynamic patterns, obesity, and pulse wave velocity in children and adolescents
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ORIGINAL ARTICLE
Ambulatory hemodynamic patterns, obesity, and pulse wave velocity in children and adolescents Stella Stabouli 1 Vasilios Kotsis 4
&
Konstantinos Kollios 2 & Thomaitsa Nika 2 & Katerina Chrysaidou 1 & Despoina Tramma 3 &
Received: 27 April 2020 / Revised: 12 June 2020 / Accepted: 25 June 2020 # IPNA 2020
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.
Keywords Ambulatory blood pressure monitoring . Pulse wave velocity . Obesity . Cardiac output . Central blood pressure . Spurious hypertension
Introduction Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00467-020-04694-1) contains supplementary material, which is available to authorized users. * Stella Stabouli [email protected] 1
1st Department of Pediatrics, Pediatric Nephrology Unit, Hippokratio Hospital, Aristotle University of Thessaloniki, 49 Konstantinoupoleos Street, 54642 Thessaloniki, Greece
2
3rd Department of Pediatrics, Hippokratio Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
3
4th Department of Pediatrics, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
4
3rd Department of Internal Medicine, Hypertension-24h ABPM Center, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
The worldwide increase in the prevalence of overweight and obesity in childhood has gi
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