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Fan B, Zhang T, Li S, Yan Y, Fan L, Bazzano L, He J, Chen W. Differential Roles of Life-Course Cumulative Burden of Cardiovascular Risk Factors in Arterial Stiffness and Thickness. Can J Cardiol 2022; 38:1253-1262. [PMID: 35314334 DOI: 10.1016/j.cjca.2022.03.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 03/08/2022] [Accepted: 03/09/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Data are limited regarding differential and common effects of cardiovascular risk factors on subclinical changes in vascular structure and function. We aimed to examine the relationships of life-course cumulative burdens of cardiovascular risk factors with adult arterial pulse wave velocity (PWV) and carotid intima-media thickness (CIMT) in a longitudinal cohort of the Bogalusa Heart Study. METHODS The cohort consisted of 900 subjects who had aortic-femoral PWV and CIMT measurements. These participants were examined 5-16 times for body mass index (BMI), blood pressure, atherogenic index of plasma (AIP), and low-density lipoprotein cholesterol (LDLC) from childhood to adulthood. The area under the curve (AUC) was calculated as a measure of long-term burden of the risk factors. RESULTS Adjusting for covariates, adult PWV was associated with AUCs of BMI, systolic blood pressure (SBP) and AIP (standardized regression coefficient [β] = 0.191, 0.321, 0.153, respectively; P < 0.001 for all). Adult CIMT was associated with AUCs of BMI, SBP, AIP and LDLC (β = 0.115, 0.202, 0.141, 0.152, respectively; P < 0.001 for all). Moreover, childhood BMI was associated with adult PWV and CIMT (β = 0.088 and 0.075, respectively; false discovery rate q values < 0.05 for both), and childhood LDLC with adult CIMT (β = 0.079; false discovery rate q value < 0.05). These associations did not differ significantly among race and sex groups. CONCLUSIONS The life-course cumulative burden of BMI, SBP, and AIP has common effects on arterial wall stiffening and thickening, whereas LDLC is specifically associated with arterial wall thickness, and this effect starts in early life.
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Affiliation(s)
- Bingbing Fan
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; National Institute of Health Data Science, Shandong University, Jinan, Shandong, China
| | - Tao Zhang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; National Institute of Health Data Science, Shandong University, Jinan, Shandong, China.
| | - Shengxu Li
- Children's Minnesota Research Institute, Children's Minnesota, Minneapolis, Minnesota, USA
| | - Yinkun Yan
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA; Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Lijun Fan
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA; Institute for Iodine Deficiency Disorders Prevention and Control, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
| | - Lydia Bazzano
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| | - Wei Chen
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
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Johnson W, Kuh D, Tikhonoff V, Charakida M, Woodside J, Whincup P, Hughes AD, Deanfield JE, Hardy R. Body mass index and height from infancy to adulthood and carotid intima-media thickness at 60 to 64 years in the 1946 British Birth Cohort Study. Arterioscler Thromb Vasc Biol 2014; 34:654-60. [PMID: 24458709 DOI: 10.1161/atvbaha.113.302572] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Atherosclerosis begins early in life and obesity is a key determinant. We investigated the role of body mass index (BMI) and height from infancy to adulthood in presenting with high adulthood carotid intima-media thickness. APPROACH AND RESULTS Odds ratios of BMI, and height Z scores at 2, 4, 6, 7, 11, 15, and 20 years, and changes between 2 and 4, 4 and 7, 7 and 15, and 15 and 20 years, for carotid intima-media thickness at 60 to 64 years in the upper quartile were estimated for 604 men and 669 women. Confounding by early-life environments, mediating by body size and cardiometabolic measures at 60 to 64 years, and effect modification were investigated. In men, there was positive association of BMI at 4 years (odds ratio, 1.256; 95% confidence interval, 1.026-1.538) and 20 years (1.282; 1.022-1.609), negative association of height at 4 years (0.780; 0.631-0.964), and negative association of height growth between 2 and 4 years (0.698; 0.534-0.913) with high carotid intima-media thickness. The childhood estimates were robust, but the estimate for BMI at 20 years was attenuated by adjustment for BMI at 60 to 64 years. The protective influence of greater early childhood height was strongest in those with the lowest systolic blood pressure at 60 to 64 years. In women, there was no pattern of association and all confidence intervals crossed 1. CONCLUSIONS Early childhood in men might be a sensitive developmental period for atherosclerosis, in which changes in BMI and height represent 2 distinct biological mechanisms. The maintenance of healthy weight in men from adolescence onward may be a useful strategy to avoid the atherosclerotic complications of adiposity tracking.
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Affiliation(s)
- William Johnson
- From the MRC Unit for Lifelong Health and Ageing at UCL (W.J., D.K., V.T., R.H.) and National Centre for Cardiovascular Prevention and Outcomes, Institute of Cardiovascular Science (M.C., J.W., J.E.D.), University College London, London, United Kingdom; Population Health Research Centre, Division of Population Health Sciences and Education, St George's University of London, London, United Kingdom (P.W.); and International Centre for Circulatory Health, National Heart & Lung Institute, Faculty of Medicine, Imperial College London, London, United Kingdom (A.D.H.)
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Chen W, Srinivasan SR, Berenson GS. Differential impact of heart rate on arterial wall stiffness and thickness in young adults: The Bogalusa Heart Study. ACTA ACUST UNITED AC 2012; 2:152-7. [PMID: 20409897 DOI: 10.1016/j.jash.2007.10.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2007] [Revised: 10/05/2007] [Accepted: 10/16/2007] [Indexed: 11/29/2022]
Abstract
Heart rate, a hemodynamic parameter, is an important determinant of arterial wall stiffness. However, information on the relationship of heart rate to arterial wall thickness is inconsistent. This study examined the influence of heart rate on arterial stiffness and thickness in Black and White young adults. The study cohort consisted of 255 Black and 659 White adults age 25 to 43 years enrolled in the Bogalusa Heart Study. Carotid artery intima-media thickness (IMT) was measured by B-mode ultrasound and aorta-femoral pulse wave velocity (af-PWV) by echo-Doppler. There was no difference in heart rate between Blacks and Whites. Males vs. females displayed lower heart rate and higher segmental and composite carotid IMT; Blacks vs. Whites had higher composite carotid IMT (0.83 mm vs. 0.80 mm, P < .01) and af-PWV (5.4 m/s vs. 5.2 m/s, P < .01). In a multivariate regression model adjusting for traditional cardiovascular risk variables, heart rate was independently associated with af-PWV (standardized regression coefficient: beta = .14, P = .01 for Blacks; beta = .06, P = .07 for Whites; beta = .09, P = .003 for total sample), but not with carotid IMT. These results indicate that heart rate plays differential roles in the development of arterial stiffness and subclinical atherosclerosis during young adulthood.
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Affiliation(s)
- Wei Chen
- Tulane Center for Cardiovascular Health and Department of Epidemiology, Tulane University Health Sciences Center, New Orleans, Louisiana, USA
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Tawadrous H, Kamran H, Salciccioli L, Schoeneman MJ, Lazar J. Evaluation of arterial structure and function in pediatric patients with end-stage renal disease on dialysis and after renal transplantation. Pediatr Transplant 2012; 16:480-5. [PMID: 22624620 DOI: 10.1111/j.1399-3046.2012.01721.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
CVD is a major cause of morbidity and mortality in pediatric patients with CKD. It is unclear whether vascular abnormalities in these patients are reversible, and if transplantation portends salutary effects on arterial function. We compared FMD, PWV, AI75, and CIMT in 15 dialysis (D), 14 transplant patients (T), and 15 controls (C), and their associations with cardiovascular risk factors. There was stepwise lower FMD (p < 0.001), higher AI75 (p < 0.001), higher PWV (p = 0.01), and higher CIMT SDS for age (p = 0.03) and height (p = 0.006) in the D group than T and C groups. FMD, PWV, and CIMT were unrelated to dialysis duration or time from transplantation. On multivariate analysis, group status was independently associated with FMD (β = 3.15, p = 0.002), AI75 (β = -5.95, p = 0.01), PWV (β = -0.57, p = 0.07) and CIMT (β = -0.02, p = 0.04) and CIMT SDS for height (β = -0.541, p = 0.009). FMD is lower and AI75, PWV and CIMT are higher in pediatric patients maintained on D than T/C. T patients have similar AI75, PWV and CIMT to C although FMD remains reduced. These findings suggest that transplantation stabilizes or improves CKD associated arteriopathy.
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Affiliation(s)
- Hanan Tawadrous
- Department of Pediatrics, Division of Pediatric Nephrology, State University of New York Downstate Medical Center, Brooklyn, NY, USA
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Salciccioli L, Kamran H, Qureshi G, Philip C, Jean-Louis G, Zizi F, Ko EH, Lazar JM. Indices of Arterial Stiffness in African American and African Caribbean Subjects. J Natl Med Assoc 2009; 101:992-8. [DOI: 10.1016/s0027-9684(15)31065-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Association of chronic periodontitis with left ventricular mass and central blood pressure in treated patients with essential hypertension. Am J Hypertens 2009; 22:203-7. [PMID: 19039308 DOI: 10.1038/ajh.2008.330] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The aim of the study was to answer the question whether chronic periodontitis (CP) in patients with essential hypertension is associated with increased aortic stiffness and increased central blood pressure (CBP), which may in turn increase left ventricular mass (LVM) in those patients. CP influences LVM in hypertensive and renal patients as well as in healthy subjects; however, mechanisms involved are not clear. METHODS Fifty patients (23 men and 27 women, 51.4 +/- 5.2 years, body mass index (BMI) 29.5 +/- 4.4 kg/m(2)) with severe CP-Community Periodontal Index of Treatment Needs (CPITN) score 3-4, and 49 patients (20 men and 29 women, 49.3 +/- 5.5 years, BMI 29.9 +/- 4.8 kg/m(2)) with no or moderate CP (CPITN 0-2) were included. In all patients LVM, pulse wave velocity (PWV), and CBP were measured, and LVM index (LVMI) calculated. RESULTS Patients with a CPITN of 3-4 had higher LVM (257.3 +/- 67.9 vs. 220.3 +/- 66.4 g, P < 0.01), LVMI (105.8 +/- 23.6 vs. 92.6 +/- 24.8 g/m(2), P < 0.01) and higher central systolic (124 +/- 17 vs. 116 +/- 15 mm Hg, P < 0.05) and pulse pressure (45 +/- 11 vs. 38.7 +/- 9.8 mm Hg, P < 0.05) as compared with patients with a CPITN of 0-2. In the univariate analysis, for the total group a positive association was observed between CPITN values and LVM, LVMI, age, aortic systolic, and pulse pressure, but not with systemic blood pressure. Linear regression analysis showed an association of borderline significance (P = 0.06) between LVMI and the CPITN value. In other model, a significant positive relationship between CBP and CPITN was observed. CONCLUSIONS More severe forms of periodontitis are associated with increased CBP and LVM in patients with primary hypertension.
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