Does arterial stiffness mediate or suppress the associations of blood pressure with cardiac structure and function in adolescents? by Andrew O Agbaje

Am J Physiol Heart Circ Physiol. 2023 Mar 17. doi: 10.1152/ajpheart.00094.2023. Online ahead of print.

ABSTRACT

There is limited understanding of the role of arterial stiffness in cardiovascular disease risk in the pediatric population, lagging behind strong evidence in the adult population. Arterial stiffness progression among adolescents with hypertension has been considered hypertension-mediated vascular damage. However, emerging pediatric reports suggest that arterial stiffness may precede increased blood pressure, and hypertension, whilst increased blood pressure from childhood has been associated with signs of cardiac damage in mid-adulthood. Thus, this study used a third variable analytical approach to examine if arterial stiffness mediates or suppresses the effects of increasing blood pressure on cardiac structure and function in the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort of 1778 adolescents. After adjusting for cardiometabolic and lifestyle factors, arterial stiffness measured as carotid-femoral pulse wave velocity partly suppressed the association of higher systolic blood pressure with higher left ventricular mass (standardized regression coefficient (β = -0.012; p = 0.017; suppression effect = 4%), partly mediated the associations of higher systolic and diastolic blood with higher relative ventricular wall thickness and partly mediated the association of higher diastolic BP with lower left ventricular diastolic function. In conclusion, increasing arterial stiffness could attenuate some of the adverse effects of increased blood pressure on cardiac structure and function in adolescents possibly by modifying the Windkessel effects.

PMID:36930657 | DOI:10.1152/ajpheart.00094.2023