Abstract：
The association of childhood blood pressure (BP) and heart rate (HR) with intermediate markers of cardiovascular disease several decades later has been shown, but studies on more short-term outcomes are scarce. Using population-based data, this study investigates the association of four BP parameters and HR in childhood with three carotid markers for vascular remodeling one decade later.
At the 11-year follow-up, 4607 participants of the nationwide KiGGS cohort aged 14 to 28 years had semi-automated sonographic carotid intima media thickness (CIMT) measurements. We investigated associations of baseline (age 3-17 years) and follow-up SBP, DBP, mean arterial pressure (MAP), pulse pressure (PP) and resting heart rate (RHR), with CIMT and lumen diameter at or above the 90th percentile and distensibility coefficient at or below the tenth percentile in logistic regressions. Analyses were further adjusted using a composite cardiovascular risk (CVR) score of BMI, triglycerides, total/HDL-cholesterol-ratio and HbA1c.
SBP, DBP, MAP and RHR were significantly and similarly associated with all carotid measures 11 years later, for example an odds ratio (OR) of 1.17 [confidence interval (CI) 1.06-1.29] for one standard deviation SBP increase with elevated CIMT when adjusting for sex, age and CVR score. Cross-sectionally, the strongest association was found for MAP with reduced distensibility coefficient (OR 1.76; CI 1.59-1.94).
This population-based cohort study shows robust and consistent associations between childhood BP and RHR and three carotid measures of vascular remodeling only one decade later, clearly underscoring the potential importance of preventing high BP already early in the life course.
At the 11-year follow-up, 4607 participants of the nationwide KiGGS cohort aged 14 to 28 years had semi-automated sonographic carotid intima media thickness (CIMT) measurements. We investigated associations of baseline (age 3-17 years) and follow-up SBP, DBP, mean arterial pressure (MAP), pulse pressure (PP) and resting heart rate (RHR), with CIMT and lumen diameter at or above the 90th percentile and distensibility coefficient at or below the tenth percentile in logistic regressions. Analyses were further adjusted using a composite cardiovascular risk (CVR) score of BMI, triglycerides, total/HDL-cholesterol-ratio and HbA1c.
SBP, DBP, MAP and RHR were significantly and similarly associated with all carotid measures 11 years later, for example an odds ratio (OR) of 1.17 [confidence interval (CI) 1.06-1.29] for one standard deviation SBP increase with elevated CIMT when adjusting for sex, age and CVR score. Cross-sectionally, the strongest association was found for MAP with reduced distensibility coefficient (OR 1.76; CI 1.59-1.94).
This population-based cohort study shows robust and consistent associations between childhood BP and RHR and three carotid measures of vascular remodeling only one decade later, clearly underscoring the potential importance of preventing high BP already early in the life course.
摘要：
目的：几十年后，儿童血压（BP）和心率（HR）与心血管疾病的中间标志物之间的关系已经被证明，但是对更多短期结果的研究很少。使用基于人口的数据，本研究调查了儿童期4个BP参数和HR与1年后血管重塑的3个颈动脉标记物的相关性.
方法：在11年的随访中，全国14至28岁的KiGGS队列的4607名参与者进行了半自动超声检查颈动脉内膜中层厚度（CIMT）测量。我们调查了基线（3-17岁）和随访SBP的关联，DBP,平均动脉压(MAP),脉压（PP）和静息心率（RHR），在逻辑回归中，CIMT和管腔直径等于或高于第90百分位，扩张性系数等于或低于第10百分位。使用BMI的复合心血管风险（CVR）评分进一步调整分析，甘油三酯，总/HDL-胆固醇比值和HbA1c。
结果：SBP，DBP,11年后，MAP和RHR与所有颈动脉测量值显著且相似。例如，当调整性别时，一个标准差SBP随CIMT升高而增加的比值比(OR)为1.17[置信区间(CI)1.06-1.29]，年龄和CVR得分。跨领域,MAP与扩张系数降低的相关性最强(OR1.76;CI1.59-1.94).
结论：这项基于人群的队列研究表明，仅十年后，儿童血压和RHR与血管重塑的三种颈动脉指标之间存在强大而一致的关联。清楚地强调了在生命过程早期预防高BP的潜在重要性。
■http://links。www.com/HJH/C301.
方法：在11年的随访中，全国14至28岁的KiGGS队列的4607名参与者进行了半自动超声检查颈动脉内膜中层厚度（CIMT）测量。我们调查了基线（3-17岁）和随访SBP的关联，DBP,平均动脉压(MAP),脉压（PP）和静息心率（RHR），在逻辑回归中，CIMT和管腔直径等于或高于第90百分位，扩张性系数等于或低于第10百分位。使用BMI的复合心血管风险（CVR）评分进一步调整分析，甘油三酯，总/HDL-胆固醇比值和HbA1c。
结果：SBP，DBP,11年后，MAP和RHR与所有颈动脉测量值显著且相似。例如，当调整性别时，一个标准差SBP随CIMT升高而增加的比值比(OR)为1.17[置信区间(CI)1.06-1.29]，年龄和CVR得分。跨领域,MAP与扩张系数降低的相关性最强(OR1.76;CI1.59-1.94).
结论：这项基于人群的队列研究表明，仅十年后，儿童血压和RHR与血管重塑的三种颈动脉指标之间存在强大而一致的关联。清楚地强调了在生命过程早期预防高BP的潜在重要性。
■http://links。www.com/HJH/C301.
