Percentiles for central blood pressure and pulse wave velocity in children and adolescents recorded with an oscillometric device

Abstract

Objective: In adults with arterial hypertension, measuring arterial stiffness by pulse wave velocity (PWV) can determine the extent of cardiovascular subclinical organ damage. PWV has independent predictive value for cardiovascular events, but there are currently no recommendations for measuring PWV in children. In addition, central systolic blood pressure (cSBP) strongly reflects vascular changes. The aim of this study was to establish percentiles for cSBP and PWV in children and adolescents to evaluate and classify altered vascular function in youths.

Methods and results: We measured PWV and cSBP with an oscillometric device with inbuilt ARCSolver-algorithm (estimated by using the brachial waveform) and calculated smoothed reference percentiles for 1445 children and young adults (49.5% female; 13.41 ± 2.80 years, range 8-22 years; PWV 4.67 ± 0.34 m/s; cSBP 100.7 ± 8.9 mmHg) using the LMS-method based on age and height. PWV and cSBP increased with age and height, but slightly differently for girls and boys, possibly reflecting different growth patterns. Between 8 and 21 years, PWV increased from 4.29 ± 0.32 to 4.98 ± 0.33 m/s in girls and from 4.27 ± 0.18 to 5.22 ± 0.46 m/s in boys. While girls showed a minor increase in cSBP (91.2 ± 7.5 to 109.1 ± 8.6 mmHg), the cSBP in boys ranged from 90.0 ± 5.8 to 110.5 ± 9.6 mmHg with a more pronounced increase between 14 and 17 years.

Conclusion: These percentiles for PWV and cSBP can help define arterial stiffness in youths and contribute to risk stratification for cardiovascular disease. For example, in children with prehypertension or isolated systolic hypertension, PWV and cSBP can provide additional information about the function of the vascular system, thereby strengthening intervention strategies.

Keywords: Arterial stiffness; Children; Non-invasive.