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Brachial-cuff excess pressure is associated with carotid intima-media thickness among Australian children: a cross-sectional population study

Peng, X, Picone, DS ORCID: 0000-0002-4760-1634, Schultz, MG ORCID: 0000-0003-3458-1811, Cai, G ORCID: 0000-0002-6481-704X, Wake, M, Burgner, DP, Mynard, JP, Ellul, S, Cheung, M, Juonala, M and Sharman, JE ORCID: 0000-0003-2792-0811 2020 , 'Brachial-cuff excess pressure is associated with carotid intima-media thickness among Australian children: a cross-sectional population study' , Hypertension Research , pp. 1-9 , doi: 10.1038/s41440-020-00576-z.

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Reservoir pressure parameters (i.e., reservoir pressure [RP] and excess pressure [XSP]) independently predict cardiovascular events in adults, but this has not been investigated in children. This study aimed to determine (1) the association of reservoir pressure parameters with carotid intima-media thickness (carotid IMT), a preclinical vascular phenotype, and (2) whether a multivariable regression model with or without reservoir pressure parameters fits better for estimating carotid IMT in children. Study participants were 11-12-year-old children (n = 1231, 50% male) from the Child Health CheckPoint study, a cross-sectional substudy of the population-based Longitudinal Study of Australian Children. RP and XSP were obtained using brachial-cuff oscillometry (SphygmoCor XCEL, AtCor, Sydney). Carotid IMT was quantified by vascular ultrasonography. XSP was associated with carotid IMT after adjusting for confounders including age, sex, BMI z-score, heart rate, pubertal stage, moderate-to-vigorous physical activity, and mean arterial pressure (β = 0.93 µm, 95% CI 0.30-1.56 for XSP peak and β = 0.04 µm, 95% CI 0.01-0.08 for XSP integral). The results of the likelihood ratio test indicated a trend that the model with XSP and the above confounders fit better than a similar model without XSP for estimating carotid IMT. Our findings indicate that brachial-cuff device-measured XSP is associated with carotid IMT independent of conventional cardiovascular risk factors, including standard BP. This implies that a clinically convenient cuff approach could provide meaningful information for the early assessment of cardiovascular risk among children.

Item Type: Article
Authors/Creators:Peng, X and Picone, DS and Schultz, MG and Cai, G and Wake, M and Burgner, DP and Mynard, JP and Ellul, S and Cheung, M and Juonala, M and Sharman, JE
Keywords: atherosclerosis, blood pressure monitor, childhood, waveform analysis
Journal or Publication Title: Hypertension Research
Publisher: Japanese Soc Hypertension Cent Academic Soc
ISSN: 0916-9636
DOI / ID Number: 10.1038/s41440-020-00576-z
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Copyright 2020 The Japanese Society of Hypertension

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