Key result
In young prepubertal children, each unit increase in BMI was associated with a 0.444% decrease in heart rate-corrected augmentation index (AIx@75).
Why the study?
Central hemodynamics relate to cardiovascular outcomes in adults, but their associations with childhood cardiovascular risk remain unclear.
Cross-Sectional (n=1,324)
In young prepubertal children, higher BMI is associated with lower augmentation of the reflected pulse wave, while higher cardiorespiratory fitness is associated with favorably lower AIx@75 and reflection magnitude.
Higher BMI-linked lower AIx in children should not change practice; hypothesis-generating for wave reflection and needs longitudinal confirmation.
Objective: Central hemodynamics are related to cardiovascular (CV) outcomes in adults, but associations with childhood CV risk remain unclear. The study aimed to investigate the association of obesity, physical activity, and fitness with parameters of central pulse wave reflection in young prepubertal children. Methods: In this cross-sectional study, 1,324 primary school children (aged 7.2 ± 0.4 years) were screened for parameters of pulse wave reflection such as augmentation index (AIx), central pulse pressure (CPP), body mass index (BMI), and cardiorespiratory fitness (CRF) by standardized procedures for children. Results: The mean AIx and AIx@75 were 22.2 ± 7.7 and 29.2 ± 9.2%, respectively. With each unit increase in BMI, AIx [−0.226 (−0.328; −0.125)%] and AIx@75 [−0.444(−0.660; −0.229)%] decreased, whereas peak forward pulse wave increased (p < 0.001). Increasing BMI was associated with higher CPP, but did not remain significant after adjustment for CRF and heart rate. One unit increase in CRF was associated with lower AIx@75 [−0.509(−0.844; −0.173)%, p = 0.003] and lower reflection magnitude [RM: −0.559 (−0.890; −0.227), p = 0.001], independent of body weight and height. Girls had significantly higher AIx, AIx@75, peak backward pulse wave, and RM compared with boys. Conclusion: Childhood obesity was associated with higher CPP but lower augmentation of the reflected pulse wave in children. Assessment of central blood pressures appears to be a valuable asset to childhood CV risk screening. The validity of augmentation indices during childhood development and the association with early vascular aging in children need to be verified in long-term follow-up studies. Physical activity and fitness have the potential to improve vascular hemodynamics in susceptible children and, thus, counteract vascular aging. Trial registry: ClinicalTrials.gov: Exercise and Arterial Modulation in Youth. Identifier: NCT02853747; URL: https://clinicaltrials.gov/ct2/show/NCT02853747 .
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Köchli et al. (2021) conducted a cross-sectional in Healthy children (cardiovascular risk screening) (n=1,324). Body mass index (BMI) vs. Lower BMI was evaluated on Change in heart rate-corrected augmentation index (AIx@75) per unit increase in BMI (MD -0.444%, 95% CI -0.660 to -0.229, p=<0.001). In young prepubertal children, each unit increase in BMI was associated with a 0.444% decrease in heart rate-corrected augmentation index (AIx@75).
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