Impacts of mid- to later childhood body build, social circumstance and blood pressure on early-adult arterial stiffness in different ethnic groups

ABSTRACT

OBJECTIVE: Arterial stiffness, measured as aortic pulse wave velocity [PWV], is a powerful prognostic indicator for cardiovascular events, displacing blood pressure (BP). Little is known of its determinants. We tested how factors measured twice previously in childhood in the MRC ‘DASH’ study, particularly body mass (BMI) components and BP, affected PWV in young adults. DESIGN AND METHODS: Of 6643 London children, aged 11-13y, from 51 schools in samples of about 1000 in 6 ethnic groups, 4785 (72% of the cohort), were seen again at 14-16y. In 2013, 666 (97% of invited) took part in a young-adult pilot (21-23y). With psychosocial, anthropometric and BP measures, PWV was recorded via an upper arm cuff on the calibrated Arteriograph device. RESULTS: PWV reproducibility was excellent, with mean differences across 3 x 6-8 cardiac cycles each of -0.06, 0.03 and 0.06 m/sec. Unadjusted PWVs in Caribbean-origin and White UK young men were similar (mean+SD 7.9+0.3 vs 7.6 +0.4 m/sec) and lower in other groups at similar SBPs (120mmHg), BMIs (24.6kg/m2) and waists (84.3cm). In full regression models, while Caribbean (higher BMIs and waists), African and Indian young women had lower PWV (by 0.5-0.8, 95%CI 0.1-1.1,m/sec) than did white UK women (6.9+0.2), values were still increased by age, BP, a powerful impact from waist/height, with a racism effect (+0.4m/sec) in women. Childhood effects of waist/hip were also detectable. CONCLUSION: Even by young adulthood, increased waist/height ratios, BP and psychosocial variables such as perceived racism were independent determinants of arterial stiffness, likely to increase with age.