title: A relation between blood pressure and stiffness of joints and skin.
abstract: BACKGROUND
  Blood pressure, particularly pulse pressure, is associated with arterial wall stiffness, but little is known about its relation to stiffness of other parts of the body. We examined the extent to which blood pressure levels in young healthy children are related to stiffness of various tissues.
  
  
  METHODS
  In November 2000, we studied 95 healthy prepubertal children (41 boys and 54 girls, within age range 8-10 years) from two primary schools in the city of Zeist, The Netherlands. Systolic and diastolic blood pressure and pulse pressure were analyzed in relation to various tissue indicators of stiffness, including active joint mobility and skin extensibility. All results were adjusted for age, sex, body height, body weight and muscle strength as possible confounders.
  
  
  RESULTS
  Diastolic blood pressure was lower with increased active joint mobility (multivariate generalized linear regression coefficient = -4.5 mmHg per standard deviation [SD] joint mobility; 95% confidence interval [CI] = -7.8 to -1.2). Pulse pressure was lower with increased skin extensibility (-3.2 mmHg per SD skin extensibility; CI = -5.2 to -1.1), through a higher diastolic blood pressure (2.0 mmHg per SD skin extensibility; CI = 0.2-3.9) and possibly lower systolic blood pressure (-0.8 mmHg per SD skin extensibility; CI = -3.5 to 1.9). These associations were mutually independent. Additional adjustment for reported musculoskeletal problems or physical activity levels did not materially change the findings.
  
  
  CONCLUSIONS
  Our findings support the hypothesis that constitutional stiffness of body tissues may be associated with blood pressure levels and eventually cardiovascular risk.
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center, Wilhelmina Children's Hospital, Ulrecht, The Netherlands. c.s.p.m.uiterwaal@jc.azu.nl
authors.forename: Cuno S P M
authors.initials: CS
authors.lastname: Uiterwaal
authors.forename: Diederick E
authors.initials: DE
authors.lastname: Grobbee
authors.forename: Ralph J B
authors.initials: RJ
authors.lastname: Sakkers
authors.forename: Paul J M
authors.initials: PJ
authors.lastname: Helders
authors.forename: Ruud A
authors.initials: RA
authors.lastname: Bank
authors.forename: Raoul H H
authors.initials: RH
authors.lastname: Engelbert
mesh_terms: D001794:Blood Pressure; D002648:Child; D015986:Confounding Factors, Epidemiologic; D004548:Elasticity; D005260:Female; D006801:Humans; D007596:Joints / Q000503:physiopathology*; D016014:Linear Models; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D011674:Pulse; D016059:Range of Motion, Articular; D012879:Skin Physiological Phenomena