1.4 CHILDHOOD DETERMINANTS OF EARLY ADULT ARTERIAL STIFFNESS IN DIFFERENT ETHNIC GROUPS

Abstract

Childhood determinants of aortic pulse wave velocity [PWV] are poorly understood. We tested how factors measured twice previously in childhood in the MRC ‘DASH’ study, particularly body mass (BMI) components and BP, affected PWV in young adults. Methods: Of 6643 London children, aged 11–13 y, from 51 schools in samples of about 1000 in 6 ethnic groups, with markedly different adult cardiovascular risk, 4785 (72%), were seen again at 14–16 y. In 2013, 666 (97% of invited) took part in a young-adult pilot (21–23 y) follow-up. With psychosocial, anthropometric and BP measures, PWV was recorded via an upper arm cuff on the calibrated Arteriograph device. In a subsample (n = 334) PA was measured over 5 days via the ActivPal. Results: Unadjusted PWVs in Black Caribbean and White UK young men were similar (mean+SD 7.9 + 0.3 vs 7.6 + 0.4 m/sec) and lower in other groups at similar systolic (s)BPs (120 mmHg) and BMIs (24.6 kg/m2). In fully adjusted regression models, independent of BP effects, while Black Caribbean (higher BMIs and waists), Black African and Indian young women had lower PWV (by 0.5–0.8, 95%CI 0.1–1.1 m/sec) than White UK women (6.9 + 0.2 m/sec), values were still increased by age, BP, powerful impacts from waist/height and time spent sedentary but a reducing impact of time walking >100steps/min (both p < 0.01), with a racism effect (+0.4 m/sec) in women. Childhood effects of waist/hip were also detectable. Conclusion: Even by young adulthood, increased waist/height ratios, lower physical activity, BP and psychosocial variables (eg: perceived racism) are independent determinants of arterial stiffness, likely to increase with age.