Temporal longitudinal associations of carotid-femoral pulse wave velocity and carotid intima-media thickness with resting heart rate and inflammation in youth.

Abstract

We examined the temporal longitudinal associations of carotid-femoral pulse wave velocity (cfPWV) and carotid intima-media thickness (cIMT) with the risk of elevated resting heart rate (RHR) and high-sensitivity C-reactive protein (hsCRP). We studied 3862 adolescents, aged 17.7 years, followed-up for 7 years, from Avon Longitudinal Study of Parents and Children. RHR, fasting hsCRP, cfPWV and cIMT were repeatedly assessed and analysed using logistic regression, linear mixed-effect, and structural equation models. Among 3862 adolescents (2143 [55.5%] female), 10% and 44% were at moderate-to-high risk of elevated RHR and hsCRP at 24.5 years, respectively. Higher cfPWV at 17.7 years was associated with elevated RHR risk at follow-up [Odds-ratio (OR) 1.58 (CI 1.20-2.08); p=0.001] whilst cIMT at 17.7 years was associated with elevated hsCRP risk [OR 2.30 (1.18-4.46); p=0.014] at follow-up, only among females. In mixed-model, 7-year progression in cfPWV was directly associated with 7-year increase in RHR [effect-estimate 6 beats/min (1-11); p=0.017] and hsCRP. cIMT progression was associated with 7-year increase in RHR and hsCRP. In cross-lagged model, higher cfPWV at 17.7 years was associated with higher RHR [β = 0.06, standard-error = 3.85, p<0.0001] at 24.5 years but RHR at 17.7 years was unassociated with cfPWV at 24.5 years. Baseline cIMT or RHR was unassociated with either outcome at follow-up. Higher hsCRP at 17.7 years was associated with higher cfPWV and cIMT at 24.5 years. In conclusion, adolescent arterial stiffness but not cIMT appears to precede higher RHR in young adulthood, whilst elevated hsCRP in adolescence preceded higher cfPWV and cIMT.