title: Assessment of vascular function in low socioeconomic status preschool children: a pilot study.
abstract: Elevated brachial blood pressure (BP) in childhood tracks into adulthood. Central BP and measures of arterial stiffness, such as aortic augmentation index (AIx) and pulse wave velocity (PWV), have been associated with future cardiovascular disease. This pilot study assessed the feasibility of noninvasively measuring these parameters in preschool children and explored factors that may be associated with elevated BP in this age group. Brachial BP was measured using an electronic oscillometric unit (Dinamap PRO 100) and defined as elevated when systolic BP (SBP) and/or diastolic BP (DBP) was ≥ the 90th percentile for age, gender, and height. Central BP, AIx, and PWV were measured using applanation tonometry (SphygmoCor). C-reactive protein (CRP) was measured in serum samples. Sixteen African-American preschool children were recruited (4.4 ± 0.8 years, 69% males), 6 (38%) of whom had an elevated brachial BP (110 ± 10/69 ± 4 vs. 96 ± 8/55 ± 6 mm Hg, Cohen's d = 2.2). Children with elevated brachial BP had higher central SBP (d = 1.6) and DBP (d = 1.96) (97 ± 6/68 ± 4 vs. 85 ± 8/57 ± 6 mm Hg), AIx (d = 0.88) (31 ± 8 vs. 18 ± 16%, standardized to heart rate), and CRP (3.1 [2.3-6.3] vs. 0.1 [0.1-0.3] mg/dL, d = 2). There was no significant difference in PWV between groups (d = 0.26). CRP and SBP (Spearman r = 0.70), DBP (r = 0.68), central SBP (r = 0.58), and central DBP (r = 0.71) were positively correlated. Wide confidence intervals for the estimated effect sizes indicated a large degree of uncertainty about all estimates due to the small sample size. Noninvasive assessment of central BP and arterial stiffness is feasible in preschool children. Vascular inflammation may be an important factor that influences BP at an early age. Further studies in preschool children are needed to elucidate mechanisms of early onset hypertension.
authors.affiliation: Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, AL, USA.
authors.forename: Lama
authors.initials: L
authors.lastname: Ghazi
authors.affiliation: Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, AL, USA.
authors.forename: Tanja
authors.initials: T
authors.lastname: Dudenbostel
authors.affiliation: Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, AL, USA.
authors.forename: Daisy
authors.initials: D
authors.lastname: Xing
authors.affiliation: School of Nursing, University of Alabama at Birmingham, AL, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Ejem
authors.affiliation: School of Nursing, University of Alabama at Birmingham, AL, USA.
authors.forename: Anne
authors.initials: A
authors.lastname: Turner-Henson
authors.affiliation: Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, AL, USA.
authors.forename: Cynthia Irwin
authors.initials: CI
authors.lastname: Joiner
authors.affiliation: School of Public Health, University of Alabama at Birmingham, AL, USA.
authors.forename: Olivia
authors.initials: O
authors.lastname: Affuso
authors.affiliation: School of Nursing, University of Alabama at Birmingham, AL, USA.
authors.forename: Andres
authors.initials: A
authors.lastname: Azuero
authors.affiliation: Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, AL, USA.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Oparil
authors.affiliation: Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, AL, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Calhoun
authors.affiliation: University of Alabama at Birmingham, AL, USA.
authors.forename: Marti
authors.initials: M
authors.lastname: Rice
authors.affiliation: Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, AL, USA; Section of Cardiology, Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA. Electronic address: fadihage@uab.edu.
authors.forename: Fadi G
authors.initials: FG
authors.lastname: Hage
mesh_terms: D001741:Black or African American; D001783:Blood Flow Velocity; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination / Q000379:methods; D002097:C-Reactive Protein / Q000032:analysis; D002675:Child, Preschool; D005240:Feasibility Studies; D005260:Female; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D009991:Oscillometry; D010865:Pilot Projects; D063177:Pulse Wave Analysis; D012307:Risk Factors; D012923:Social Class; D059289:Vascular Stiffness / Q000502:physiology*; D014657:Vasculitis / Q000097:blood / Q000150:complications
chemical_list: D002097:C-Reactive Protein
keywords: Aortic stiffness; hypertension; vascular inflammation