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Measuring Cardiac Autonomic Nervous System (ANS) Activity in Children
Published on: April 29, 2013
An Assessment of the Paediatric Cardiovascular Risk Profile in San Nicola da Crissa, a Village in the Calabria Region
Francesco Martino1, Angela Sciacqua2, Tarcisio Niglio3
1Department of Internal Medicine, Anaesthesiology, and Cardiovascular Sciences, La Sapienza University of Rome, 00161 Rome, Italy.
Insights
Early atherosclerosis screening in children is vital. Many kids show signs of subclinical atherosclerosis, linked to cholesterol and family history, emphasizing early intervention for cardiovascular health.
Area of Science:
- Cardiovascular Research
- Pediatric Cardiology
- Preventive Medicine
Background:
- Atherosclerosis begins in childhood, posing long-term cardiovascular risks.
- Primary prevention strategies in pediatric patients remain understudied.
- Early identification of at-risk children is crucial for mitigating future adverse events.
Purpose of the Study:
- To assess subclinical atherosclerosis markers in children and compare them with their parents.
- To investigate the relationship between carotid intima-media thickness (IMT), carotid stiffness, blood pressure, and lipid profiles in children.
- To explore familial influences and risk factors for early-onset atherosclerosis.
Main Methods:
- Recruited 54 children and 72 parents for the study.
- Measured blood pressure (BP), lipid panels, carotid intima-media thickness (IMT), and carotid stiffness indexes.
- Analyzed correlations between vascular parameters, cholesterol levels, and parental data.
Main Results:
- 31% of children exhibited pathological IMT, indicating widespread subclinical atherosclerosis.
- Children's IMT correlated with cholesterol levels and diastolic BP.
- Significant differences in lipid profiles were observed between children and parents, with children with hypercholesterolemia being three times more likely to have pathological IMT.
- Shared pathological IMT was common in children and their parents, suggesting familial predisposition.
Conclusions:
- Carotid stiffness similarities between children and parents suggest early familial influences on vascular health.
- The high prevalence of pathological IMT in children underscores the need for early screening and management of atherosclerosis.
- Cholesterol levels are a key factor associated with pathological IMT in children, highlighting the importance of lipid screening.
Abstract:
Background. Atherosclerosis is a long-standing process that starts in childhood and leads to a number of major adverse cardiovascular events in adulthood. It is therefore crucial that children at potential risk of atherosclerosis-related harmful consequences are identified. Nevertheless, relatively few studies have focused on primary prevention in paediatric patients. Methods. Fifty-four children (mean age 9.0 ± 2.8 years) and 72 parents (mean age 44.0 ± 8.2 years) were recruited. Blood pressure (BP) was measured and lipid panel was checked, together with carotid intima-media thickness (IMT) and several indexes of carotid stiffness. Results. No statistically significant differences in IMT and indexes of carotid stiffness were detected between children and parents, with the exception of the alpha index (p < 0.05). In children, IMT was correlated with the alpha index (p = 0.01). Seventeen children (31%) had a pathological IMT. The diastolic BP difference between children with normal and pathological IMT was statistically significant (p < 0.05). Parents' total, LDL and HDL cholesterol, as well as triglyceride levels, differed statistically from those of children with both physiological and pathological IMT: p < 0.05 for all differences. Children with hypercholesterolemia had a three-fold higher likelihood of having a pathological IMT than children with normal cholesterol (p < 0.01). Among children with pathological IMT, 59 percent had one and 41 percent had two parents who were affected by pathological IMT. Conclusions. Carotid stiffness was similar in children and their parents, suggesting early familial influences on vascular properties. Many children had a pathological carotid IMT, highlighting how subclinical atherosclerosis is diffuse even at a young age. IMT in children was associated with cholesterol levels, underscoring the importance of early lipid screening and management. The strong association between pathological IMT in both children and their parents supports the hypothesis of a shared genetic or environmental predisposition to early vascular alterations.
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