Blood Pressure and Body Weight Have Different Effects on Pulse Wave Velocity and Cardiac Mass in Children.

<strong>Background: </strong>High blood pressure (BP) and excess weight can lead to early cardiovascular organ damage already in children. Carotid-femoral pulse wave velocity (cf-PWV) is the non-invasive gold standard method for assessing aortic stiffness, while carotid-radial PWV (cr-PWV) provides information on the distensibility of the upper limb arteries. The aim of this study was to evaluate the relationship of BP and BMI z-scores with arterial stiffness and left ventricular mass index (LVMI) in a pediatric population. <strong>Methods: </strong>In 343 children (57.7% males; age ± SD 11.7 ± 2.9 years), systolic (SBP) and diastolic (DBP) BP, BMI, cf-PWV, cr-PWV and LVMI were measured. A multiple linear regression model was used to assess the impact of BMI and SBP (or DBP) z-scores on cf-PWV, cr-PWV and LVMI. <strong>Results: </strong>About 21% of children were normal weight, 34% were overweight and 45% obese. Adjusted for possible confounders, SBP and DBP z-scores were significantly associated with cf-PWV (<em>p</em> &lt; 0.001), while only DBP z-scores were related to cr-PWV (<em>p</em> &lt; 0.01). BMI was neither associated with cf-PWV nor with cr-PWV values but was a strong predictor of LVMI (&lt;0.001), whereas cardiac mass and BP z-scores were not related. <strong>Conclusions: </strong>Our study suggests that, in children, elevated BP values and excess weight may have different effects on the heart and the vessels in causing early cardiovascular alterations.**背景：** 高血压（blood pressure, BP）与体重超标可在儿童期即引发早期心血管器官损伤。颈动脉-股动脉脉搏波速度（carotid-femoral pulse wave velocity, cf-PWV）是评估主动脉僵硬度的无创金标准方法，而颈动脉-桡动脉脉搏波速度（carotid-radial PWV, cr-PWV）可反映上肢动脉的扩张性。本研究旨在探讨儿童人群中血压与BMI z评分同动脉僵硬度及左心室质量指数（left ventricular mass index, LVMI）之间的关联。**方法：** 本研究纳入343名儿童（其中男性占57.7%，年龄均值±标准差为11.7±2.9岁），对其收缩压（systolic blood pressure, SBP）、舒张压（diastolic blood pressure, DBP）、BMI、cf-PWV、cr-PWV及LVMI进行了检测。采用多重线性回归模型评估BMI及SBP（或DBP）z评分对cf-PWV、cr-PWV及LVMI的影响。**结果：** 本研究对象中约21%为体重正常者，34%为超重者，45%为肥胖者。校正潜在混杂因素后，SBP及DBP z评分与cf-PWV呈显著相关（p < 0.001），而仅DBP z评分与cr-PWV相关（p < 0.01）。BMI与cf-PWV、cr-PWV均无关联，但却是LVMI的强预测因子（p < 0.001），而心脏质量与血压z评分无相关性。**结论：** 本研究表明，在儿童群体中，血压升高与体重超标在引发早期心血管改变时，对心脏与血管的影响可能存在差异。