Evaluation of the associations of body height with blood pressure and early-stage atherosclerosis in Chinese adults

Evaluating the Arterial Stiffness as a Useful Tool in the Management of Obese Children

Childhood obesity speeds up the development of arterial stiffness and progressively increases the values of arterial pressure. The purpose of this study is to investigate the value of using pulse wave analysis (PWA) to measure arterial stiffness as a sign of vascular wall impairment in obese children. The research was focused on 60 subjects: 33 obese and 27 normal-weight. Ages ranged from 6 to 18 years old. PWA includes parameters such as pulse wave velocity (PWV), augmentation index (AIx), peripheral and central blood pressure (SBP, DBP, cSBP, cDBP), heart rate, and central pulse pressure (cPP). The device used was a Mobil-O-Graph. Blood parameters were taken from the subject's medical history, not older than 6 months. A high BMI and a large waist circumference are linked to a high PWV. The levels of LDL-c, triglycerides (TG), non-HDL-c, TG/HDL-c ratio, and total cholesterol-HDL-c ratio significantly correlate to PWV, SBP, and cSBP. Alanine aminotransferase is a reliable predictor of PWV, AIx, SBP, DBP, and cDBP, while aspartate aminotransferase is a significant predictor of AIx, mean arterial pressure (MAP), cSBP, and cPP. 25-OH-Vitamin D negatively correlates with PWV, SBP, and MAP and significantly predicts the MAP. Cortisol and TSH levels are not significant to arterial stiffness in obese children without specific comorbidities and neither is fasting glucose in obese children without impaired glucose tolerance. We conclude that PWA contributes valuable data regarding patients' vascular health and should be considered a reliable tool in the management of obese children.

An XGBoost-based model for assessment of aortic stiffness from wrist photoplethysmogram

BACKGROUND AND OBJECTIVE

Carotid-femoral pulse wave velocity (cf-PWV) is the gold standard for non-invasive assessment of aortic stiffness. Photoplethysmography used in wearable devices provides an indirect measurement method for cf-PWV. This study aimed to construct a cf-PWV prediction method based on the XGBoost algorithm and wrist photoplethysmogram (wPPG) for the early screening of arteriosclerosis in primary healthcare.

METHODS

Data from 210 subjects were used for modeling, and 100 subjects were used as an external validation set. The wPPG pulse waves were filtered by discrete wavelet transform, and various features were extracted from each waveform, including two original indexes. The extraction rate (ER) and Pearson P were calculated to evaluate the applicability of each feature for model training. The magnitude of cf-PWV was predicted by an XGBoost-based model using the selected features and basic physiological parameters (age, sex, height, weight and BMI). The level of aortic stiffness was classified by a 3-classification strategy according to the standard cf-PWV (measured by the Complior device). Bland-Altman plot, Pearson correlation analysis, and accuracy tested performance from two aspects: predicting the magnitude of cf-PWV and classifying the level of aortic stiffness.

RESULTS

In the external validation set (n = 100, age range 22-79), 97 subjects obtained features (ER = 97%). The predicted cf-PWV was significantly correlated with the standard cf-PWV (r = 0.927, P < 0.001). The accuracy (AC) of the 3-classification was 85.6%. The interrater agreement for assessing aortic stiffness was at least substantial (quadratically weighted Kappa = 0.833).

CONCLUSIONS

The multi-parameter fusion cf-PWV prediction method based on the XGBoost algorithm and wPPG pulse wave analysis proves the feasibility of atherosclerosis screening in wearable devices.

The Oscillometric Pulse Wave Analysis Is Useful in Evaluating the Arterial Stiffness of Obese Children with Relevant Cardiometabolic Risks

Early detection of all complications of childhood obesity is imperative in order to minimize effects. Obesity causes vascular disruptions, including early increased arterial stiffness and high blood pressure. This study’s aim is to assess the reliability of pulse wave analysis (PWA) in obese children and how additional risk factors influence the evaluated parameters. We analyzed 55 children aged 6–18 years old by measuring their pulse wave velocity (PWV), augmentation index (AIx), peripheral blood pressure (SBP, DBP), heart rate, central blood pressure (cSBP, cDBP) and central pulse pressure (cPP). We used the oscillometric IEM Mobil-O-Graph and performed a single-point brachial measurement. The subjects were divided into two groups: obese (n = 30) and normal-weight (n = 25) and were clinically and anamnestically assessed. BMI and waist circumference are significantly correlated to higher values for PWV, SBP, DBP, cSBP, and cDBP. Weight significantly predicts PWV, SBP, DBP and cPP. The risk factors that significantly influence the PWA and BP values are: a cardiometabolically risky pregnancy (higher PWV, AIx, SBP), active and passive smoking (higher PWV, SBP, cSBP, cDBP), sleep deprivation (higher PWV, SBP, cSBP) and sedentariness (higher PWV, AIx, peripheral and central BP). We conclude that obese children with specific additional cardiometabolic risk factors present increased arterial stiffness and higher blood pressure values.

Height is Inversely Associated with Biomarkers of Intracranial Atherosclerotic Disease in Older Adults of Amerindian Ancestry: Exploring the Obesity Paradox

BACKGROUND

Various anthropometric measurements have been inversely associated with atherosclerosis, giving rise to the concept of an "obesity paradox" However, inconsistent study results make it difficult to determine the best anthropometric measurement with which to assess such inverse relationship. Height has been inversely associated with atherosclerosis and it is unlikely to be associated with unexpected biases. In this study, we aimed to assess the association between height and other anthropometric measurements and intracranial atherosclerotic disease (ICAD).

METHODS

Community-dwelling older adults enrolled in the Three Villages Study received anthropometric measurements, high-resolution head CT (to evaluate calcium content in carotid siphons) and time-of-flight MRA (to assess stenosis of large intracranial arteries). Logistic regression models were fitted to assess the independent association between each anthropometric measurements and the presence of ICAD, after adjusting for relevant confounders. Estimated adjusted proportions were used to show how increases of different anthropometric measurements impacted ICAD log odds and corresponding odds ratios.

RESULTS

A total of 581 individuals were enrolled. Height was the single variable inversely associated with ICAD at the mean of other anthropometric measurements (OR: 0.954; 95% C.I.: 0.918 - 0.991; p=0.016). Every additional cm of height reduced by 4.6% the probability of having ICAD. The significance of other anthropometric measurements vanished in multivariate models with height as an independent variable.

CONCLUSIONS

This study demonstrates a robust inverse association between height and ICAD in Amerindians and opens new avenues of research for a better understanding of the obesity paradox in diverse ethnic groups.