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6.4 LONGITUDINAL FOLLOW-UP OF ARTERIAL DISTENSIBILITY IN EARLY CHILDHOOD: ROLES OF BIRTH WEIGHT, GROWTH, BLOOD PRESSURE AND EARLIER (AORTIC) ‘STIFFNESS’
oleh: A. Vyas, J. Kips, I. Gemell, N. Howard, F. Khan, P. Clayton, J.K. Cruickshank
| Format: | Article |
|---|---|
| Diterbitkan: | BMC 2009-12-01 |
Deskripsi
Background: Although blood pressure (BP) ‘tracks’ from early life in humans, little is known of how arterial stiffness develops over time in early childhood. Methods: UK born European (n=208) and South Asian (SA, n=99) origin infants had standardised measures of anthropometry, BP (Dynamap Critikon) and pulse wave velocity (aPWV – Doppler method, aortic arch to bifurcation) taken within 72h of birth and at any of 3–6 months, 1,2,3 and 4 years later. Data were analysed using mixed cross-sectional/longitudinal (MXLS) and fully longitudinal (FL) regression models in STATA. Results: SA neonates averaged 330g lighter and 1.2cm shorter at birth than Europeans. After increasing between 0–3 months, neither mean (95%CI) aPWV (6.1 (5.7–6.5) m/sec) nor systolic or diastolic BPs (±86/ 45 mmHg) changed greatly from 1–4 years. However, in MXLS, aPWV was related to weight (β=0.85p<0.001), subscapular skinfold (β=0.21, p<0.001), systolic (β=0.02, p=0.04) or diastolic (β= −0.26, p=0.03) BP, weakly to height (p=0.07) but not to age, gender, ethnicity, pulse pressure nor heart rate. In FL models, aPWV at 3 years (n=77) and 4 years (n=59), was not determined by BPs, birth weight, weight change, skinfold, length nor prior aPWV readings. Conclusion: These first longitudinal data in early childhood suggest that previous data, even on BP, ignoring genuine within-person change or lack of change, may be confounded. While weight and central fat (skinfold) affect overall MXLS results, early arterial distensibility & BPs appear not to alter much from 3 months to 4 years.