1 - Unidade de Nefrologia Pediátrica, Hospital D. Estefânia, Unidade Local de Saúde São José, Lisboa, Portugal. Centro Clínico Académico de Lisboa, Lisboa, Portugal
2 - NOVA Medical School / Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal.
- An. Nefrol. Pediátr. 2024; 1(9): 277-283
Abstract: Cardiovascular disease (CVD) is the leading cause of death and loss of disability-adjusted life years worldwide. Identifying individuals at high risk for CVD early in life remains a major public health priority. The concept of vascular age has improved traditional risk stratification for CVD. Children with hypertension show signs of premature vascular ageing, suggesting their vascular age is four to five years older than that of their normotensive peers. This phenotype continues in adulthood, probably reflecting haemodynamic stress and cardiometabolic/inflammatory-driven changes in the vascular system as part of an accelerated biological maturation profile. Increased carotid-femoral pulse wave velocity, the gold standard measurement of arterial stiffness and premature vascular ageing, is an age-independent predictor of CVD-associated and all-cause mortality. Halting or reversing the markers of vascular ageing is emerging as a potential strategy to tailor the treatment of hypertension in young populations. A deeper understanding of why some individuals are highly susceptible to CVD, while others seem to be relatively protected throughout life, may help further individualize approaches to the prevention, follow-up, and treatment of paediatric hypertension.
Keywords: Arterial stiffness, cardiovascular disease, child, early vascular ageing, hypertension, pulse wave velocity