Arterial Stiffness and Pulse-Pressure Amplification in Overweight/Obese African-American Adolescents: Relation With Higher Systolic and Pulse Pressure

作者：Pierce Gary L^*; Zhu Haidong; Darracott Katherine; Edet Itoro; Bhagatwala Jigar; Huang Ying; Dong Yanbin

来源：American Journal of Hypertension, 2013, 26(1): 20-26.

DOI：10.1093/ajh/hps014

• augmentation index
• wave reflection
• aortic stiffness
• pulse wave velocity
• pediatric hypertension
• obesity
• blood pressure
• hypertension

BACKGROUND %26lt;br%26gt;Obesity is associated with a higher systolic blood pressure (BP) and pulse pressure (PP) in African-American youths, increasing their risk for developing hypertension. However, it is unknown whether arterial stiffness and wave reflection are associated with a higher systolic BP and PP or with smaller PP amplification in overweight/obese (OW/OB) African-American adolescents. %26lt;br%26gt;METHODS %26lt;br%26gt;We measured carotid-femoral pulse wave velocity (CF-PWV), carotid-radial PWV (CR-PWV), the augmentation index (AIx) adjusted to a heart rate of 75 bpm (AI75), the augmentation pressure (AugP), PP amplification, and body composition in 227 healthy African-American adolescents (age, 16.9 +/- 0.2 years; 54% male). %26lt;br%26gt;RESULTS %26lt;br%26gt;Adolescents who were OW/OB (n = 86, body mass index (BMI) %26gt;= 85th percentile) demonstrated 5%-6%, 13%-16%, and 2.5% higher aortic and brachial systolic BP, brachial and aortic PP, and mean arterial pressure (MAP), respectively (all P %26lt; 0.05), than adolescents of normal-weight (NW, n = 141, BMI %26lt; 85th percentile). The OW/OB adolescents had a 7% higher CF-PWV, 5% lower CR-PWV, and 3.5% lower PP amplification than the NW group (all P %26lt; 0.05), but no differences in AI75 or AugP. In the entire cohort after adjustment for age, sex, heart rate, height, and MAP, CF-PWV was positively correlated, and CR-PWV and PP amplification were negatively correlated, with total and abdominal/hip adiposity. Additionally, CF-PWV, AI75, and AugP were positively correlated with MAP and negatively correlated with PP amplification. CR-PWV, AI75, and AugP were negatively correlated with brachial and aortic PP. %26lt;br%26gt;CONCLUSIONS %26lt;br%26gt;Higher aortic stiffness is associated with smaller PP amplification with increasing adiposity in African-American adolescents. Whether a reduction in PP amplification predicts increased CVD risk in obese African-American adolescents requires further study.

• 出版日期2013-1