Purpose In middle-aged and older adults, arterial stiffness is a significant predictor of cardiovascular morbidity and mortality. Pulse wave velocity (PWV) is a frequently used direct measure of arterial stiffness. Little is known about the determinants of PWV in youth and young adults. We sought to investigate PWV in a large cohort of white and black youth and young adults.
Methods As part of a larger twin study, radial-carotid (r-c) and carotid-dorsalis pedis (c-d) PWV was measured using applanation tonometry with the SphygmoCor system in 702 subjects (41% black, 49% male) aged 12-30 years (mean: 17.7 ± 3.3). Ethnicity and gender differences were tested and associations investigated with age, body mass index (BMI), systolic (SBP) and diastolic blood pressure (DBP), and pulse pressure (PP) in each ethnicity by gender group. Multiple regression was used to determine the independent predictors of r-c and c-d PWV.
Results r-c and c-d PWV were moderately correlated (range: 0.31-0.51). Both were significantly increased in blacks compared to their white counterparts, but there was no significant gender difference. In both blacks and whites, age for c-d PWV and DBP for both r-c and c-d PWV showed the strongest positive correlations (range: 0.31-0.62). SBP was correlated to c-d PWV to a lesser degree (range: 0.16-0.37). BMI was correlated to c-d PWV in whites only (range: 0.17-0.24). There was no positive correlation with pulse pressure. Using multiple regression analysis, age, ethnicity, BMI, DBP, and SBP were shown to explain 18.8% and 34.4% of the variance in r-c and c-d PWV, respectively. Age, ethnicity, and DBP were the most important predictors with the greatest effect in these final models.
Conclusions Arterial stiffness increases with age even in a population of youth and young adults. Ethnic differences in arterial stiffness seem to be established by adolescence. DBP as opposed to PP is the strongest predictor of PWV in young individuals.
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