Pulse wave velocity and augmentation index, but not intima-media thickness, are early indicators of vascular damage in hypercholesterolemic children

P>Background Arterial stiffness is an important determinant of cardiovascular risk. It is associated with several cardiovascular risk factors, including hypertension, diabetes and cigarette smoking. However, there are conflicting data about the relationship between arterial stiffness and hypercholesterolemia. Furthermore, augmentation index (AIx), a measure of systemic arterial stiffness, has not been previously investigated in hypercholesterolemic (HCh) children. Aim of our study was to evaluate local and systemic arterial stiffness as well as carotid intima-media thickness (IMT) in HCh children and also to investigate the relation between serum cholesterol levels and arterial stiffness. Materials and methods We determined lipid profile, body mass index, blood pressure, heart rate, carotid IMT and several arterial stiffness parameters, as beta-index, elastic modulus (E-p), arterial compliance (AC), pulse wave velocity (PWV) and AIx, in 44 untreated HCh children (mean age 10 center dot 7 +/- 2 center dot 8 years; 18 with familial hypercholesterolemia, FH, and 26 with primary hypercholesterolemia, PHC) and 18 age- and sex-matched controls. HCh children never received any medication, including antihypertensive and lipid lowering drugs. Results Respect to controls and to PHC, FH had significantly higher (P < 0 center dot 001) beta-index (5 center dot 22 +/- 1 center dot 13 vs. 3 center dot 13 +/- 0 center dot 74 and 3 center dot 60 +/- 1 center dot 02), PWV (4 center dot 72 +/- 0 center dot 72 m s-1 vs. 3 center dot 66 +/- 0 center dot 55 m s-1 and 4 center dot 10 +/- 0 center dot 67 m s-1), AIx (3 center dot 55 +/- 3 center dot 97% vs. -4 center dot 43 +/- 4 center dot 09% and 0 center dot 61 +/- 2 center dot 39%) and E-p (64 center dot 4 +/- 19 center dot 6 kPa vs. 36 center dot 2 +/- 11 center dot 3 kPa and 42 center dot 9 +/- 13 center dot 1), whereas AC (1 center dot 25 +/- 0 center dot 48 mm2 kPa-1 vs. 1 center dot 9 +/- 0 center dot 43 mm2 kPa-1 and 1 center dot 62 +/- 0 center dot 43 mm2 kPa-1) was lower (P < 0 center dot 001). There was no significant difference in carotid IMT and blood pressure values between the groups. The multiple regression analysis showed a significant association of arterial stiffness values with plasma cholesterol levels (P < 0 center dot 0001). Conclusion Our findings show that local and systemic arterial stiffness are increased in asymptomatic, normotensive HCh children, suggesting that HCh plays a key role in arterial mechanical impairment since the paediatric age.