Childhood pulse pressure predicts subclinical vascular damage in adulthood

OBJECTIVE: We aimed to investigate associations of childhood pulse pressure (PP) and change in PP status with adult subclinical vascular damage. METHODS: Data were obtained from a population-based cohort of children aged 6-18 years started in 1987. The study constituted 1254 participants who were followed up in 2010-2011 (aged 28-42 years). Carotid arteriosclerosis and aortic stiffness were assessed by carotid intima-media thickness (IMT) and brachial-ankle pulse wave velocity (PWV), respectively. RESULTS: Both childhood PP and mean arterial pressure (MAP) were independently associated with adult carotid IMT and PWV adjusted for sex, childhood age, follow-up duration, and other traditional cardiovascular risk factors. After further adjustment for adult values of PP and MAP, childhood PP was still associated with adult carotid IMT but not with PWV, whereas childhood MAP was associated with adult PWV but not with carotid IMT. In addition, compared with participants who had normal PP in both childhood and adulthood, participants who had high PP in adulthood, irrespective of their childhood PP status, had higher levels of carotid IMT and PWV (all P < 0.05). Participants who had high PP in childhood and normal PP in adulthood also had higher levels of adult carotid IMT but similar levels of PWV compared with participants who had consistently normal PP. CONCLUSION: Large PP in childhood plays an important role in the development of subclinical vascular damage in adulthood. These findings underscore the importance of early prevention of large PP to reduce future risk of cardiovascular disease.