title: Aortic Pulse Wave Velocity in Healthy Children and Adolescents: Reference Values for the Vicorder Device and Modifying Factors.
abstract: BACKGROUND
  Aortic pulse wave velocity (PWV), an indicator of arterial stiffness, independently predicts cardiovascular mortality risk in adults. Arterial stiffening advances with age and seems accelerated in children with certain disease conditions such as chronic kidney disease or diabetes. The Vicorder, an oscillometric device to measure PWV, has been validated in children, but reference values in a large pediatric cohort, association to carotid stiffness and influence of individual and family risk factors have not been determined.
  
  
  METHODS
  Pulse waves were captured in 1,003 healthy children (aged 6-18 years) in 6 centers and gender-specific reference data normalized to age/height were constructed. In 589 children carotid distensibility and intima media thickness were measured. Gestational and family history was reported.
  
  
  RESULTS
  PWV correlated with age (r = 0.57, P < 0.0001) with significant gender-related differences starting at age 9. Further significant correlations were seen for height, weight, body mass index, blood pressure, pulse pressure, and heart rate. Independent predictors for PWV in a multivariate regression analysis were gender, age, height, weight, mean arterial pressure, and heart rate. Risk factors for higher PWV included small for gestational age at birth, secondhand smoking, parental hypertension, and obesity. PWV showed weak correlations with 2 of the carotid distensibility measures, but not with intima media thickness.
  
  
  CONCLUSIONS
  This study defines reference values for PWV captured by the Vicorder device in children and adolescents and reveals associations with potential cardiovascular risk factors in a healthy population. Gender-specific percentiles for age/height will allow for the assessment of pediatric cohorts using this oscillometric method.
authors.affiliation: Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany;
authors.forename: Daniela
authors.initials: D
authors.lastname: Thurn
authors.affiliation: Division of Pediatric Nephrology, Center for Pediatric and Adolescent Medicine, Heidelberg, Germany;
authors.forename: Anke
authors.initials: A
authors.lastname: Doyon
authors.affiliation: Division of Pediatric Nephrology, Ege University Medical Faculty, Izmir, Turkey;
authors.forename: Betul
authors.initials: B
authors.lastname: Sözeri
authors.affiliation: Department of Pediatric Nephrology, Faculty of Medicine, Cukurova University, Adana, Turkey;
authors.forename: Aysun K
authors.initials: AK
authors.lastname: Bayazit
authors.affiliation: Department of Pediatric Nephrology, Istanbul University, Cerrahpasa Medical School, Istanbul, Turkey;
authors.forename: Nur
authors.initials: N
authors.lastname: Canpolat
authors.affiliation: Division of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey;
authors.forename: Ali
authors.initials: A
authors.lastname: Duzova
authors.affiliation: Department of Pediatric Nephrology, Charité Universitätsmedizin Berlin, Germany;
authors.forename: Uwe
authors.initials: U
authors.lastname: Querfeld
authors.affiliation: Department of Nephrology, Hannover Medical School, Hannover, Germany.
authors.forename: Bernhard M W
authors.initials: BM
authors.lastname: Schmidt
authors.affiliation: Division of Pediatric Nephrology, Center for Pediatric and Adolescent Medicine, Heidelberg, Germany;
authors.forename: Franz
authors.initials: F
authors.lastname: Schaefer
authors.affiliation: Division of Pediatric Nephrology, Center for Pediatric and Adolescent Medicine, Heidelberg, Germany;
authors.forename: Elke
authors.initials: E
authors.lastname: Wühl
authors.affiliation: Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany;
authors.forename: Anette
authors.initials: A
authors.lastname: Melk
mesh_terms: D000293:Adolescent; D059168:Carotid Intima-Media Thickness; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D063177:Pulse Wave Analysis; D012016:Reference Values
keywords: arterial stiffness; blood pressure; cardiovascular; hypertension; pediatrics; pulse wave velocity; risk factors.