Blood Pressure and Body Weight Have Different Effects on Pulse Wave Velocity and Cardiac Mass in Children

Simonetta Genovesi; Paolo Salvi; Elisa Nava; Elena Tassistro; Marco Giussani; Ilaria Desimone; Antonina Orlando; Mariagrazia Battaglino; Giulia Lieti; Massimo Montemerlo; Laura Antolini; Gianfranco Parati

doi:10.3390/jcm9092954

Blood Pressure and Body Weight Have Different Effects on Pulse Wave Velocity and Cardiac Mass in Children

J Clin Med. 2020 Sep 12;9(9):2954. doi: 10.3390/jcm9092954.

Authors

Affiliations

¹ School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy.
² Istituto Auxologico Italiano, IRCCS, Cardiologic Unit, 20100 Milan, Italy.
³ Nephrology and Dialysis Unit, IRCCS Multimedica, 20099 Sesto S. Giovanni, Italy.
⁴ Bicocca Center of Bioinformatics, Biostatistics and Bioimaging (B4 center), School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy.
⁵ Family Pediatrician, Agenzia Tutela Salute of Milan, 20100 Milan, Italy.
⁶ Division of Nephrology and Dialysis, Magenta Hospital, ASST Ovest Milan, 20025 Legnano, Italy.

Abstract

Background: High blood pressure (BP) and excess weight can lead to early cardiovascular organ damage already in children. Carotid-femoral pulse wave velocity (cf-PWV) is the non-invasive gold standard method for assessing aortic stiffness, while carotid-radial PWV (cr-PWV) provides information on the distensibility of the upper limb arteries. The aim of this study was to evaluate the relationship of BP and BMI z-scores with arterial stiffness and left ventricular mass index (LVMI) in a pediatric population.

Methods: In 343 children (57.7% males; age ± SD 11.7 ± 2.9 years), systolic (SBP) and diastolic (DBP) BP, BMI, cf-PWV, cr-PWV and LVMI were measured. A multiple linear regression model was used to assess the impact of BMI and SBP (or DBP) z-scores on cf-PWV, cr-PWV and LVMI.

Results: About 21% of children were normal weight, 34% were overweight and 45% obese. Adjusted for possible confounders, SBP and DBP z-scores were significantly associated with cf-PWV (p < 0.001), while only DBP z-scores were related to cr-PWV (p < 0.01). BMI was neither associated with cf-PWV nor with cr-PWV values but was a strong predictor of LVMI (<0.001), whereas cardiac mass and BP z-scores were not related.

Conclusions: Our study suggests that, in children, elevated BP values and excess weight may have different effects on the heart and the vessels in causing early cardiovascular alterations.

Keywords: blood pressure; body mass index; carotid-femoral pulse wave velocity; carotid-radial pulse wave velocity; children; left ventricular mass index.