Increased systolic blood pressure and insulin resistance partially mediated relationship
By Elana Gotkine HealthDay Reporter
TUESDAY, Aug. 22, 2023 (HealthDay News) — For adolescents, arterial stiffness progression precedes worsening structural and functional cardiac damage, according to a study published online Aug. 3 in Atherosclerosis.
Andrew O. Agbaje, M.D., M.P.H., from the University of Eastern Finland in Kuopio, and colleagues examined the temporal longitudinal associations of carotid-femoral pulse wave velocity (cfPWV) and carotid intima-media thickness (cIMT) with left ventricular hypertrophy (LVH) and diastolic dysfunction (LVDD) in a cohort of 1,856 adolescents (mean age, 17.7 years) followed for seven years.
The researchers found that the prevalence of LVH increased from 3.6 to 7.2 percent and that of LVDD increased from 11.1 to 16.3 percent during follow-up. In the total cohort, males, those with overweight/obesity, and normotensive individuals, high cfPWV progression was associated with worsening increased LV filling pressure E/e’ wave ratio (hiLVFP). Similarly, in the total cohort, females, and individuals with normal weight, high cfPWV progression was associated with worsening hiLVFP. In the total cohort and those with overweight/obesity and elevated blood pressure/hypertension, high cIMT progression was associated with worsening LVH. In the total cohort, there was no association for cfPWV or cIMT progression with worsening increased relative wall thickness (hiRWT). Higher baseline cfPWV was associated with future LV mass indexed for height2.7 (LVMI2.7), RWT, LVD function E/A wave ratio, and LV filling pressure E/e’ wave ratio in cross-lagged models. The direct associations of cumulative cfPWV with cumulative LVMI2.7 were mediated by cumulative increased systolic blood pressure and insulin resistance (34.3 and 15.1 percent mediation, respectively).
“Experimental and clinical intervention studies are urgently needed on comprehensive approaches to treating and reversing arterial stiffness from adolescence,” Agbaje said in a statement. “At least, targeting blood pressure and insulin resistance leaves the problem half-solved.”
Copyright © 2023 HealthDay. All rights reserved.
