title: High Central Aortic Rather than Brachial Blood Pressure is Associated with Carotid Wall Remodeling and Increased Arterial Stiffness in Childhood.
abstract: BACKGROUND
  In adults, central blood pressure (cBP) is reported to associate target organ damages (TODs) rather than peripheral blood pressure (pBP). However, data regarding the association of pre-clinical TODs with cBP and pBP in pediatric populations are scarce.
  
  
  OBJECTIVE
  To evaluate in children and adolescents the importance of cBP and pBP levels, in terms of their association with hemodynamic and vascular changes.
  
  
  METHODS
  315 subjects [age (mean/range) 12/8-18 years] were included.
  
  
  METHODS
  pBP (oscillometry, Omron-HEM433INT and Mobil-O-Graph), cBP levels and waveforms (oscillometry, Mobil-O-Graph; applanation tonometry, SphygmoCor), aortic wave reflection-related parameters, carotid intima-media thickness (CIMT) and carotid (elastic modulus, stiffness-index) and aortic stiffness (carotid-femoral pulse wave velocity, PWV). Four groups were defined considering pBP and cBP percentiles (th): cBP ≥90th, cBP <90th, pBP ≥90th, pBP <90th. In each group, haemodynamic and vascular parameters were compared for subgroups defined considering the level of the remaining blood pressure (cBP or pBP). Subgroups were matched for anthropometric and cardiovascular risk factors (propensity matching-score).
  
  
  RESULTS
  Subjects with high cBP showed a worse cardiovascular risk profile in addition to worse peripheral hemodynamic conditions. The CIMT, carotid and aortic stiffness levels were also higher in those subjects. CIMT and carotid stiffness remained statistically higher when subjects were matched for pBP and other cardiovascular risk factors. There were no differences in arterial properties when subjects were analyzed (compared) considering similar pBP levels, during normal and high cBP conditions.
  
  
  CONCLUSIONS
  Compared with pBP, the cBP levels show a greater association with vascular alterations (high CIMT and arterial stiffness), in children and adolescents.
authors.affiliation: Physiology Department, School of Medicine, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Republic University, General Flores 2125, 11800, Montevideo, Uruguay.
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Peluso
authors.affiliation: Physiology Department, School of Medicine, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Republic University, General Flores 2125, 11800, Montevideo, Uruguay.
authors.forename: Victoria
authors.initials: V
authors.lastname: García-Espinosa
authors.affiliation: Physiology Department, School of Medicine, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Republic University, General Flores 2125, 11800, Montevideo, Uruguay.
authors.forename: Santiago
authors.initials: S
authors.lastname: Curcio
authors.affiliation: Physiology Department, School of Medicine, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Republic University, General Flores 2125, 11800, Montevideo, Uruguay.|Basic Medicine Department, School of Medicine, Clinical Hospital, Republic University, Avenida Italia w/n, 11600, Montevideo, Uruguay.
authors.forename: Marco
authors.initials: M
authors.lastname: Marota
authors.affiliation: Physiology Department, School of Medicine, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Republic University, General Flores 2125, 11800, Montevideo, Uruguay.
authors.forename: Juan
authors.initials: J
authors.lastname: Castro
authors.affiliation: Pediatric Cardiology Department, Pediatric Hospital Center Pereira-Rossell, ASSE, Ministry of Public Health, Boulevard Artigas 1550, 11600, Montevideo, Uruguay.
authors.forename: Pedro
authors.initials: P
authors.lastname: Chiesa
authors.affiliation: Pediatric Clinic "C", School of Medicine, Republic University, Pediatric Hospital Center Pereira-Rossell, ASSE, Ministry of Public Health, Boulevard Artigas 1550, 11600, Montevideo, Uruguay.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Giachetto
authors.affiliation: Physiology Department, School of Medicine, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Republic University, General Flores 2125, 11800, Montevideo, Uruguay.
authors.forename: Daniel
authors.identifier: http://orcid.org/0000-0001-7160-7166
authors.initials: D
authors.lastname: Bia
authors.affiliation: Physiology Department, School of Medicine, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Republic University, General Flores 2125, 11800, Montevideo, Uruguay. yana@fmed.edu.uy.
authors.forename: Yanina
authors.initials: Y
authors.lastname: Zócalo
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001011:Aorta / Q000503:physiopathology*; D062186:Arterial Pressure; D001795:Blood Pressure Determination / Q000379:methods; D001916:Brachial Artery / Q000503:physiopathology*; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*; D059168:Carotid Intima-Media Thickness; D016009:Chi-Square Distribution; D002648:Child; D055119:Elastic Modulus; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D016015:Logistic Models; D008297:Male; D008365:Manometry; D009991:Oscillometry; D015995:Prevalence; D011379:Prognosis; D057216:Propensity Score; D063177:Pulse Wave Analysis; D012307:Risk Factors; D014583:Uruguay / Q000453:epidemiology; D066253:Vascular Remodeling; D059289:Vascular Stiffness
keywords: Arterial stiffness; Carotid artery intima-media thickness; Central aortic blood pressure; Children; Pulse wave velocity; Target organ damage