Hyperdynamic Circulation and Cardiovascular Risk in Children and Adolescents

BACKGROUND: Hyperdynamic circulation has been reported to be associated with adverse levels of insulin, blood pressure, adiposity, and lipoproteins in the adult population. Whether this putatively insulin-mediated association also occurs in early life is not known. This aspect was examined in 2229 children and adolescents 8 to 17 years old living in Bogalusa, La. METHODS AND RESULTS: Individuals were categorized as hyperdynamic (pulse pressure and heart rate in the upper quartile of the race-sex-age distribution), intermediate, and hypodynamic (pulse pressure and heart rate in the bottom quartile). Systolic blood pressure was significantly greater with a hyperdynamic circulation in both sexes (P < .0001), and several measures of obesity were greater with a hyperdynamic circulation. Hyperdynamic circulation was associated with statistically significant increases in triglyceride (P < .05) and fasting insulin (P < .01) in boys independently of age, race, and obesity. A decreasing trend with HDL cholesterol (P = .06) was also observed in boys. A significant association with total cholesterol (P < .05) was observed only in girls. In the analysis stratified by percent body fat, many of these features still occurred in obese individuals (top quartile) but not in lean individuals (bottom quartile). Further, when a subset of this cohort (n = 1074) was followed over a 3-year period, the above trend persisted significantly in boys. CONCLUSIONS: The present study demonstrates that a hyperdynamic state as defined is associated with increased insulin levels and an adverse cardiovascular risk in early life.