Key result
Obesity and higher systolic BP associate with increased PWV and reduced PBR in young adults.
Why the study?
Obesity and arterial hypertension in young adults are recognized cardiovascular risk factors that contribute to arterial stiffness, but their relationship to target organ damage and endothelial glycocalyx integrity in this population required investigation.
In healthy young adults, cardiovascular risk factors such as increased weight and systolic blood pressure are already independently associated with early signs of target organ damage, including arterial stiffness and endothelial changes.
Early vascular changes may warrant risk factor monitoring in young adults; extends prior data on onset timing but leaves causality and intervention effects open.
Baseline: The presence of obesity or/and arterial hypertension in young adults represent well recognized risk factors for later cardiovascular (CV) events during adult life. Obesity and arterial hypertension contribute to increased arterial stiffness, another important CV risk factor. The integrity of endothelial glycocalyx (EG), as part of the endothelium, plays a vital role in vascular permeability, inflammation, and elasticity and finally to CV disease. We investigated the relationship between obesity and arterial hypertension to target organ damage (TOD) as arterial stiffness and endothelial function in young adults. Methods: A group of 66 healthy young adults, 16-26 years old, was evaluated regarding the presence of CV risk factors [obesity, systolic (SBP) and diastolic (DBP) blood pressure] and TOD (arterial stiffness, EG integrity). Carotid-femoral arterial stiffness (PWV) was measured by Complior apparatus. Increased perfusion boundary region (PBR) of the sublingual arterial microvessels (5-25 micrometers) was measured as a non-invasive accurate index of reduced EG thickness and subsequent endothelial dysfunction. Results: Population was divided in Group A (young males, n=33, 20+2 years, BMI=27+5) and Group B (young females, n=33, 20+2 years, BMI=24+4). Young males had increased BMI (27+5 vs. 24+4, p=0.02), elevated SBP (124+9 vs. 111+8, p<0.001), increased PWV (8+1 vs. 7+1m/sec, p=0.002) and reduced PBR5-25 (1.79+0.2 vs. 1.98+2μm, p=0.001) compared to young females. In the whole population, i. weight was related to PBR5-25 (ρ=-0.23, p=0.05), SBP (r=0.60, p<0.001), DBP (ρ=0.27, p=0.03) and PWV (r=.33, p=0.007) and ii. SBP was related to PBR5-25 (r=-0.34, p=0.005) and PWV (r=0.57, p<0.001). In a multiple regression analysis (age, weight and SBP were inserted as independent variables), we found that PBR5-9 was independently associated with SBP (beta=-0.59, p<0.001) and weight (beta=0.43, p=0.004) while PWV was independently associated with SBP (beta=0.56, p<0.001) Conclusions: In early adulthood, independent associations between CV risk factors (obesity and arterial hypertension), and TOD (arterial stiffness and endothelial function) already exist. However, endothelial glycocalyx integrity remains despite weight and blood pressure increase. Our results underscore the need of primary prevention of future CV events by keeping body weight and BP within optimal levels, even in young adults.
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Triantafyllidi et al. (2025) studied this question. In young adults, obesity and higher systolic BP independently associate with increased arterial stiffness (PWV) and reduced endothelial glycocalyx integrity (PBR).
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