Tran Andrew H, Urbina Elaine M
The Heart Center, Nationwide Children's Hospital, Columbus, OH, USA.
Department of Pediatrics, The Ohio State University, Columbus, OH, USA.
Curr Atheroscler Rep. 2023 Apr;25(4):119-126. doi: 10.1007/s11883-023-01089-z. Epub 2023 Feb 27.
Cardiovascular (CV) risk factors such as dyslipidemia, hypertension, diabetes, and obesity are associated with an increased risk for CV events in adults. Noninvasive measures of vascular health are associated with these CV events and can potentially help risk stratify children with CV risk factors. The purpose of this review is to summarize recent literature regarding vascular health in children with cardiovascular risk factors.
Adverse changes in pulse wave velocity, pulse wave analysis, arterial distensibility, and carotid intima-media thickness are seen in children with CV risk factors supporting potential utility in risk stratification. Assessing vascular health in children can be challenging due to growth-related changes in vasculature, multiple assessment modalities, and differences in normative data. Vascular health assessment in children with cardiovascular risk factors can be a valuable tool for risk stratification and help identify opportunities for early intervention. Future areas of research include increasing normative data, improving conversion of data between different modalities, and increasing longitudinal studies in children linking childhood risk factors to adult CV outcomes.
血脂异常、高血压、糖尿病和肥胖等心血管（CV）危险因素与成人发生心血管事件的风险增加相关。血管健康的非侵入性测量与这些心血管事件相关，并且可能有助于对有心血管危险因素的儿童进行风险分层。本综述的目的是总结近期关于有心血管危险因素儿童血管健康的文献。
在有心血管危险因素的儿童中可见脉搏波速度、脉搏波分析、动脉扩张性和颈动脉内膜中层厚度的不良变化，这支持了其在风险分层中的潜在效用。由于血管系统与生长相关的变化、多种评估方式以及正常数据的差异，评估儿童的血管健康具有挑战性。对有心血管危险因素的儿童进行血管健康评估可以成为风险分层的有价值工具，并有助于确定早期干预的机会。未来的研究领域包括增加正常数据、改善不同方式之间的数据转换，以及增加对儿童的纵向研究，将儿童期危险因素与成人心血管结局联系起来。
