Factors associated with arterial stiffness in children aged 9-10 years

Batista, Milena Santos; Mill, José Geraldo; Pereira, Taisa Sabrina Silva; Fernandes, Carolina Dadalto Rocha; Molina, Maria del Carmen Bisi

doi:10.1590/S0034-8910.2015049005425

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Original Articles • Rev. Saúde Pública 49 • 2015 • https://doi.org/10.1590/S0034-8910.2015049005425 copy

Factors associated with arterial stiffness in children aged 9-10 years

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE

To analyze the factors associated with stiffness of the great arteries in prepubertal children.

METHODS

This study with convenience sample of 231 schoolchildren aged 9-10 years enrolled in public and private schools in Vitória, ES, Southeastern Brazil, in 2010-2011. Anthropometric and hemodynamic data, blood pressure, and pulse wave velocity in the carotid-femoral segment were obtained. Data on current and previous health conditions were obtained by questionnaire and notes on the child’s health card. Multiple linear regression was applied to identify the partial and total contribution of the factors in determining the pulse wave velocity values.

RESULTS

Among the students, 50.2% were female and 55.4% were 10 years old. Among those classified in the last tertile of pulse wave velocity, 60.0% were overweight, with higher mean blood pressure, waist circumference, and waist-to-height ratio. Birth weight was not associated with pulse wave velocity. After multiple linear regression analysis, body mass index (BMI) and diastolic blood pressure remained in the model.

CONCLUSIONS

BMI was the most important factor in determining arterial stiffness in children aged 9-10 years.

Child; Pulse Wave Analysis; Blood Flow Velocity; Vascular Stiffness; Risk Factors; Overweight

Variable	Pulse wave velocity (m/s)						p	Total
	< 5.1		5.1 a 5.5		> 5.5			n	%

	n	%	n	%	n	%
Sex							0.16
Masculine	37	33.0	38	34.0	37	33.0		112	50.0
Feminine	50	45.0	35	31.0	27	24.0		112	50.0
Socioeconomic class							0.56
A+B	44	39.0	33	29.0	36	32.0		113	52.0
C+D	39	37.0	37	36.0	28	27.0		104	48.0
Nutritional status							0.01
Normal weight	54	44.0	45	36.0	25	20.0		124	56.0
Overweight	33	33.0	28	28.0	38	39.0		99	44.0
Systolic blood pressure*							0.44
Normal	85	39.0	71	33.0	60	28.0		216	96.0
High	2	25.0	2	25.0	4	50.0		8	4.0
Diastolic blood pressure*							0.88
Normal	84	38.0	71	33.0	63	29.0		218	97.0
High	3	50.0	2	33.0	1	17.0		6	3.0
Birth weight							0.59
Normal	74	38.0	64	33.0	58	29.0		196	87.0
Low	13	47.0	9	32.0	6	41.0		28	13.0
Preterm							0.97
Yes	9	40.0	7	30.0	7	30.0		23	10.0
No	78	39.0	65	33.0	57	28.0		200	90.0

Variable	Pulse wave velocity tertile (m/s)									p
	< 5.1			5.1 a 5.5			> 5.5

	n	Mean	SD	n	Mean	SD	n	Mean	SD
SBP (mm/Hg)^a	87	103	9	73	103	9	64	108^c	9	< 0.01
DBP (mm/Hg)^a	87	62	7	73	63	8	64	66^c	7	< 0.01
Weight (kg)^a	87	35.1	7.6	73	37.3	9.7	64	41.5^c	11	< 0.01
Height (cm)^a	87	140	7	73	141	7	64	142	7	0.18

	n	Median	P₂₅;P₇₅	n	Median	P₂₅;P₇₅	n	Median	P₂₅;P₇₅

WC (cm)^b	87	60.8	55.7;67.2	72	60.6	56;73.2	63	66.3^c	59.1;75.6	< 0.01
W/H (cm)^b	87	0.43	0.41;0.49	72	0.43	0.39;0.51	63	0.48^c	0.42;0.53	< 0.01
BMI (kg/m²)^b	87	17.2	15.5;19.9	73	17.6	15.4;22.1	64	20.2^c	16.9;23.3	< 0.01

Variable	Pulse wave velocity (m/s)						p	Total
	< 5.1		5.1-5.5		> 5.5			n	%

	n	%	n	%	n	%
Birth weight (kg)							0.68
≤ 2,999	33	43.0	24	32.0	19	25.0		76	34.0
3,000 to 3,499	28	35.0	29	37.0	22	28.0		79	35.0
≥ 3,500	26	38.0	20	29.0	23	33.0		69	31.0
SBP (mmHg)							0.19
≤ 100	35	44.0	28	36.0	16	20.0		79	35.0
101 to 107	31	41.0	21	28.0	23	31.0		75	33.0
≥ 108	21	30.0	24	34.0	25	36.0		70	31.0
DBP (mmHg)							0.01
≤ 59	39	50.0	24	31.0	15	19.0		78	35.0
60 to 65	32	43.0	25	34.0	17	23.0		74	33.0
≥ 66	16	22.0	24	33.0	32	45.0		72	32.0
BMI (kg/m²)							0.01
≤ 16.4	33	44.0	29	38.0	14	18.0		76	34.0
16.4 to 20.2	36	48.0	18	24.0	21	28.0		75	34.0
≥ 20.3	18	25.0	26	35.0	29	40.0		73	33.0

Variable	Pulse wave velocity (m/s)
Variable	r	p
SBP^a (mmHg)	0.19	< 0.01
DBP^a (mmHg)	0.22	< 0.01
WC^b (cm)	0.19	< 0.01
W/H^b (cm)	0.18	< 0.01
Weight^a (kg)	0.24	< 0.01
Height^a (cm)	0.08	0.23
BMI^b (kg/m²)	0.20	< 0.01
Birth weight^a (g)	0.08	0.24

Explanatory variables	Estimated coefficient	Standard error	t	Beta	P
Constant	4.047	0.317	12.763		< 0.01
BMI (kg/m²)	0.028	0.010	2.684	0.197	< 0.01
DBP (mm/Hg)	0.012	0.005	2.321	0.157	0.02

Faculdade de Saúde Pública da Universidade de São Paulo Avenida Dr. Arnaldo, 715, 01246-904 São Paulo SP Brazil, Tel./Fax: +55 11 3061-7985 - São Paulo - SP - Brazil
E-mail: revsp@usp.br

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[1] Correspondence: Maria del Carmen Bisi Molina. Departamento de Nutrição – UFES. Av. Marechal Campos, 1468 Maruípe. 29043-900 Vitória, ES, Brasil. E-mail:maria.molina@ufes.br