Brachial-cuff excess pressure is associated with carotid intima-media thickness among Australian children: a cross-sectional population study.
Reservoir pressure parameters (i.e., reservoir pressure [RP] and excess pressure [XSP]) independently predict cardiovascular events in adults, but this has not been investigated in children. This study aimed to determine (1) the association of reservoir pressure parameters with carotid intima-media thickness (carotid IMT), a preclinical vascular phenotype, and (2) whether a multivariable regression model with or without reservoir pressure parameters fits better for estimating carotid IMT in children. Study participants were 11-12-year-old children (n = 1231, 50% male) from the Child Health CheckPoint study, a cross-sectional substudy of the population-based Longitudinal Study of Australian Children. RP and XSP were obtained using brachial-cuff oscillometry (SphygmoCor XCEL, AtCor, Sydney). Carotid IMT was quantified by vascular ultrasonography. XSP was associated with carotid IMT after adjusting for confounders including age, sex, BMI z-score, heart rate, pubertal stage, moderate-to-vigorous physical activity, and mean arterial pressure (β = 0.93 µm, 95% CI 0.30-1.56 for XSP peak and β = 0.04 µm, 95% CI 0.01-0.08 for XSP integral). The results of the likelihood ratio test indicated a trend that the model with XSP and the above confounders fit better than a similar model without XSP for estimating carotid IMT. Our findings indicate that brachial-cuff device-measured XSP is associated with carotid IMT independent of conventional cardiovascular risk factors, including standard BP. This implies that a clinically convenient cuff approach could provide meaningful information for the early assessment of cardiovascular risk among children.
['Peng|Xiaoqing|X|', 'Picone|Dean S|DS|', 'Schultz|Martin G|MG|', 'Cai|Guoqi|G|', 'Wake|Melissa|M|', 'Burgner|David P|DP|', 'Mynard|Jonathan P|JP|', 'Ellul|Susan|S|', 'Cheung|Michael|M|', 'Juonala|Markus|M|', 'Sharman|James E|JE|']
Atherosclerosis Blood pressure monitor Childhood Waveform analysis