March 6, 2009Open Access
View Full PaperPulse Pressure in Youth and Carotid Intima-Media Thickness in Adulthood
Key Result
Each 10 mm Hg increment in adolescent pulse pressure was associated with a 0.008-mm increase in adult carotid intima-media thickness 21 years later (95% CI, 0.003 to 0.013 mm; P=0.0029).
Study Design
Type
Cohort (n=2,146)
Structured PICO
Does exposure to large pulse pressure in childhood predict increased carotid artery intima-media thickness in adulthood?
P
Population
2,146 adults from the Cardiovascular Risk in Young Finns Study with blood pressure data from childhood (ages 3 to 18 years) followed for 21 years.
E
Exposure
Exposure to large pulse pressure in childhood/adolescence
O
Outcome
Carotid artery intima-media thickness in adulthoodsurrogate
Exposure to wide pulse pressure in adolescence is independently associated with increased carotid intima-media thickness in adulthood, suggesting early pulse pressure widening contributes to atherosclerosis development.
Main Result
Mean Difference: 0.008 (95% CI 0.003–0.013)
p-value: p=0.0029
Abstract
BACKGROUND AND PURPOSE: Large pulse pressure associates with atherosclerosis, but it is unclear if it contributes to the development of atherosclerosis or if atherosclerosis leads to pulse pressure widening. We examined whether exposure to large pulse pressure in childhood predicts carotid artery intima-media thickness in adulthood. METHODS: Carotid intima-media thickness was measured in 2146 adults in the Cardiovascular Risk in Young Finns Study. These subjects have blood pressure data available dating back to their childhood (baseline in 1980, ages 3 to 18 years). RESULTS: Baseline pulse pressure measured in adolescence was significantly related to carotid intima-media thickness measured in adulthood 21 years later (r=0.123, P<0.0001). The relation remained significant (P=0.0029) in models adjusted for age, sex, adolescent mean arterial pressure, adult systolic pressure, adult pulse pressure, body mass index, smoking, physical activity, and carotid artery diameter. Each 10 mm Hg increment in pulse pressure was associated with a 0.008-mm (95% CI, 0.003 to 0.013 mm) increase in carotid intima-media thickness. CONCLUSIONS: Exposure to wide pulse pressure in adolescence may induce changes that contribute to carotid artery intima-media thickening.