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. 2022 Jun 1;149(6):e2021054201.
doi: 10.1542/peds.2021-054201.

Cardiovascular Risk Factors and Target Organ Damage in Adolescents: The SHIP AHOY Study

Joshua J Price  1 , Elaine M Urbina  2 , Kristen Carlin  1 , Richard Becker  2 , Stephen R Daniels  3 , Bonita E Falkner  4 , Michael Ferguson  5 , Coral Hanevold  1 , Stephen R Hooper  6 , Julie R Ingelfinger  7 , Marc B Lande  8 , Lisa J Martin  2 , Kevin Meyers  9 , Mark Mitsnefes  2 , Bernard Rosner  10 , Joshua Samuels  11 , Joseph T Flynn  1
Affiliations

Cardiovascular Risk Factors and Target Organ Damage in Adolescents: The SHIP AHOY Study

Joshua J Price et al. Pediatrics. .

Abstract

Background: Development of cardiovascular disease in adults has been directly linked to an adverse metabolic phenotype. While there is evidence that development of these risk factors in childhood persists into adulthood and the development of cardiovascular disease, less is known about whether these risk factors are associated with target organ damage during adolescence.

Methods: We collected data from 379 adolescents (mean age 15.5, 60% male) with blood pressure between the 75th and 95th percentile to determine if there is a metabolic phenotype that predicts cardiovascular changes (left ventricular mass, systolic and diastolic function, pulse wave velocity, and renal function). We determined the number of risk factors for cardiovascular disease (hypertension, dyslipidemia, obesity, and insulin resistance) present in each participant. Generalized linear models were constructed to determine if the number of cardiovascular risk factors (CVRFs) were associated with measures of target organ damage.

Results: The number of CVRFs present were associated with statistically significant differences in increased left ventricular mass index, increased pulse wave velocity, decreased peak longitudinal strain, urine albumin to creatine ratio and echocardiographic parameters of diastolic dysfunction. Generalized linear models showed that dyslipidemia and insulin resistance were independently associated with markers of diastolic dysfunction (P ≤ .05) while increased blood pressure was associated with all makers of target organ damage (P ≤ .03).

Conclusions: These data suggest the of the number of CVRFs present is independently associated with early changes in markers of target organ damage during adolescence.

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Conflict of interest statement

CONFLICT OF INTEREST DISCLOSURES: The authors have indicated they have no financial relationships relevant to this article to disclose.

Figures

FIGURE 1
FIGURE 1
Left ventricular mass index, cardiac diastolic function and pulse wave velocity stratified by number of cardiovascular risk factors. Each marker of target organ dysfunction differed in each comparison. P ≤ .001 for left ventricular mass index and pulse wave velocity. P = .03 for E/e’. CVRFs, cardiovascular risk factors
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