Arterial stiffness and central blood pressure in non-systemic juvenile idiopathic arthritis: a cross-sectional study

Juvenile idiopathic arthritis (JIA), one of the most common chronic inflammatory diseases in childhood, may affect cardiovascular health. We aimed to compare non-invasive markers of arterial stiffness (AS) in children with JIA and healthy children. This was a cross-sectional study of patients with non-systemic JIA with a disease duration of 6 months or longer at the time of enrollment, along with healthy children. Peripheral and central blood pressure (BP), pulse wave velocity (PWV), and augmentation index (AIx) were obtained with an ambulatory BP device. Left ventricular function was evaluated with echocardiography. A total of 46 patients with JIA and 65 healthy children were included. The age, gender, SDSs of height, body weight, and body mass index were similar between groups. Peripheral systolic and diastolic BPs, mean arterial pressure, central systolic and diastolic BPs, and central pulse pressure measurements were significantly higher in the patient group (p < 0.05). While the AIx was comparable, the PWV was significantly higher in the patients. There were no differences between left ventricular functions. The patient and physician assessments on visual analogue scales were not correlated with any of the cardiovascular indices. Neither disease activity nor corticosteroid treatment was associated with PWA measurements in the patient group. Higher PWV was independently associated with age and SBP, and not with other variables included in the model.

We found that children with non-systemic JIA exhibit higher PWV and peripheral and central BPs, which may be associated with an increased risk of future structural changes. Further research with larger cohorts is needed to confirm cardiovascular implications in JIA patients..

• Arterial stiffness (AS) is an independent predictive biomarker for cardiovascular events and can be assessed noninvasively using pulse wave analysis, a valid and reliable method. • Beyond disease-specific complications, patients with juvenile idiopathic arthritis (JIA) are increasingly recognized to be at heightened risk for cardiovascular complications, driven by contributing factors such as chronic inflammation, long-term corticosteroid use, and endothelial dysfunction.

• Children diagnosed with non-systemic JIA may exhibit higher pulse wave velocity (PWV), as well as elevated peripheral and central blood pressure values, thereby increasing the risk of development of structural changes in the left ventricle. • TEarly monitoring of vascular health in patients with non-systemic JIA is important, even though they exhibit a lower inflammatory response compared to the systemic subtype, and the monitoring may help prevent future cardiovascular complications.