Carotid artery intima-media thickness (CIMT) as a vascular subclinical marker of cardiovascular risk

  • Dr Vesna Herceg-Cavrak, Children's Hospital Zagreb, Department of Pediatrics, Cardiology Unit, Klaiceva 16, Zagreb, Croatia
  • Dr Maja Batinica, Children's Hospital Zagreb, Department of Pediatrics, Cardiology Unit, Klaiceva 16, Zagreb, Croatia
  • Dr Igor Boric, Children's Hospital Zagreb, Department of Pediatrics, Cardiology Unit, Klaiceva 16, Zagreb, Croatia
  • Professor, PhD Jadranka Bozikov, Andrija Stampar School of Public Health, Croatia
  • BACKGROUND: Child with coronary artery disease evolve as a new specialty. Assessment of traditional cardiovascular risk factors is mainstay of evaluation. Subclinical markers, cardiac and especially vascular, are helpful because they are sensitive to early and less atherosclerotic load. CIMT is an independent predictor of future cardiovascular events. OBJECTIVE: In children with esential hypertension determine CIMT and investigate whether there exists an association between CIMT and left ventricle mass index (LVMI). METHODS: A cross-sectional study of 32 subjects (mean age 15.3 yr, SD 1.7 yr) was conducted. The inclusion criteria were: (1) children ages 10-18 years with hypertension, defined as average systolic and/or diastolic blood pressure that is ≥95th percentile for gender, age, and height on 3 or more separate occasions; (2) secondary hypertension exclusion; (3) no drugs with effect on blood pressure. CIMT measurements made of far wall from proximal and distal common carotid on both the right and left sides (mean of 4 measuraments). The correlation among CIMT and LVMI was determined using the Pearson correlation coefficient. RESULTS: The prevalence of left ventricle hypertrophy (LVMI > 38.6 g/m2.7) was 31.3%. CIMT was positively correlated with LVMI (r = 0.30; p = 0.09). CONCLUSIONS: Positive correlation between CIMT and LVMI is probably due to the same adaptational mechanisms and, as assessment of CIMT in adults is widely accepted as a valid and reliable measure of atherosclerotic burden, based on this and many other studies in children, these markers represent the end result of risk exposures in children as well.