Department of Clinical Physiology, Tampere University Hospital, PO Box 2000, FI-33521 Tampere, Finland.
Hypertension. 2010 Mar;55(3):806-11. doi: 10.1161/HYPERTENSIONAHA.109.145102. Epub 2010 Jan 18.
Limited and partly controversial data are available regarding the relationship of arterial pulse wave velocity and childhood cardiovascular risk factors. We studied how risk factors identified in childhood and adulthood predict pulse wave velocity assessed in adulthood. The study cohort consisted of 1691 white adults aged 30 to 45 years who had risk factor data available since childhood. Pulse wave velocity was assessed noninvasively by whole-body impedance cardiography. The number of conventional childhood and adulthood risk factors (extreme quintiles for low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, systolic blood pressure, body mass index, and smoking) was directly associated with pulse wave velocity in adulthood (P=0.005 and P<0.0001, respectively). In multivariable regression analysis, independent predictors of pulse wave velocity were sex (P<0.0001), age (P<0.0001), childhood systolic blood pressure (P=0.002) and glucose (P=0.02), and adulthood systolic blood pressure (P<0.0001), insulin (P=0.0009), and triglycerides (P=0.003). Reduction in the number of risk factors (P<0.0001) and a favorable change in obesity status (P=0.0002) from childhood to adulthood were associated with lower pulse wave velocity in adulthood. Conventional risk factors in childhood and adulthood predict pulse wave velocity in adulthood. Favorable changes in risk factor and obesity status from childhood to adulthood are associated with lower pulse wave velocity in adulthood. These results support efforts for a reduction of conventional risk factors both in childhood and adulthood in the primary prevention of atherosclerosis.
关于动脉脉搏波速度与儿童期心血管危险因素的关系，目前仅有有限且存在部分争议的数据。我们研究了儿童期和成年期确定的危险因素如何预测成年期评估的脉搏波速度。该研究队列包括 1691 名年龄在 30 至 45 岁之间的白种成年人，他们自儿童期开始就有危险因素数据。脉搏波速度通过全身阻抗心动描记术进行无创评估。传统的儿童期和成年期危险因素（极低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、收缩压、体重指数和吸烟的极端五分位数）的数量与成年期的脉搏波速度直接相关（P=0.005 和 P<0.0001）。在多变量回归分析中，脉搏波速度的独立预测因子为性别（P<0.0001）、年龄（P<0.0001）、儿童期收缩压（P=0.002）和血糖（P=0.02）以及成年期收缩压（P<0.0001）、胰岛素（P=0.0009）和甘油三酯（P=0.003）。从儿童期到成年期，危险因素数量的减少（P<0.0001）和肥胖状况的有利变化（P=0.0002）与成年期脉搏波速度较低相关。儿童期和成年期的传统危险因素可预测成年期的脉搏波速度。从儿童期到成年期，危险因素和肥胖状况的有利变化与成年期较低的脉搏波速度相关。这些结果支持在动脉粥样硬化的一级预防中，在儿童期和成年期减少传统危险因素的努力。
