Risk factor patterns and vascular health in children with incident hypertension: The ExAMIN Youth SA study

Area of Science:

• Pediatric Cardiology
• Cardiovascular Epidemiology
• Nutritional Science

Background:

• Childhood cardiovascular risk factors contribute to early-onset cardiovascular disease and hypertension.
• Understanding these risk factors in preadolescent children is crucial for preventing long-term vascular complications.

Purpose of the Study:

• To investigate cardiovascular risk factor patterns in preadolescent children (ages 5-9).
• To analyze the associations between these patterns and measures of macro- and microvasculature, stratified by blood pressure (BP) status.

Main Methods:

• Exploratory factor analysis was used to identify risk factor patterns (FPS) in 1043 children from the ExAMIN Youth SA study.
• Measurements included anthropometry, cardiorespiratory fitness, dietary intake, office BP, central pulse wave velocity (PWV), central retinal artery (CRAE), central retinal vein equivalent (CRVE), and their ratio (AVR).

Main Results:

• Three factor pattern scores (FPS) were identified. FPS1 (unhealthy foods) and FPS2 (healthy foods/SES) were present in both normotensive and hypertensive groups.
• FPS3 (BMI, BP) was unique to the normotensive group. PWV associated with FPS3 in normotensive children and FPS2 in hypertensive children.
• CRAE and AVR inversely associated with FPS3 in normotensive children but with FPS1 in hypertensive children. CRVE positively associated with FPS3 in normotensive children.

Conclusions:

• Unhealthy dietary patterns in childhood negatively impact vascular health, particularly in the context of developing hypertension.
• These effects are evident from a young age (as early as five years), underscoring the importance of early lifestyle interventions.
• Specific risk factor patterns have differential associations with vascular measures depending on blood pressure status in preadolescent children.