Evolution of the Arterial Structure and Function From Infancy to Adolescence Is related to Anthropometric and Blood Pressure Changes

Abstract

Objective— To develop a normative data set and to study the relationship among arterial structure, different anthropometric measures, blood pressure, and arterial function during healthy childhood using very-high-resolution ultrasound (25–55 MHz). Methods and Results— In 135 healthy children between 0 and 18 years of age, we assessed the structure of the carotid arteries, larger peripheral arteries, aorta, and left ventricle with ultrasound. Arterial stiffness was assessed by pulse wave velocity and endothelial function by brachial flow-mediated dilation. Reference curves adjusted for age and body surface area of arterial lumen diameters, intima-media thickness, and adventitia thickness were developed. Arterial walls thicken during childhood predominantly as a result of a progressive increase in intima-media thickness. There were significant associations among lumen diameter ( R 2 range, 0.20–0.88 for different arteries; P <0.001), intima-media thickness ( R 2 range, 0.47–0.85; P <0.001), left ventricular mass ( R 2 =0.90; P <0.001), and adventitia thickness ( R 2 range, 0.15–0.22; P <0.001) with sex, age, body surface, and systolic blood pressure. Arterial wall stress was associated with lumen diameter ( R 2 range, 0.52–0.83; P <0.001) and intima-media thickness ( R 2 range, 0.53–0.88; P <0.001). Limited relationships were found among arterial wall layer thickness, stiffness, and endothelial function. Conclusion— In healthy children, the evolution of the arterial structure is mainly related to anthropometrics and blood pressure.