In the young population, arterial stiffness, an emerging risk factor for hypertension, indirectly increases blood pressure via increased insulin resistance but not via increased body fat, concludes an article published in Frontiers in Cardiovascular Medicine.
A worldwide effort is deployed for screening, identification and early diagnosis of hypertension in order to prevent this “silent killer disease” and its sequelae from the beginning of life. There remain gaps in knowledge regarding the pathways by which blood pressure elevates, even in normal-weight populations who are physically active and have healthy lifestyle choices.
It is well known that obesity increases the risk of hypertension. Researchers have recently shown that arterial stiffness, which has been established as a causative risk factor for hypertension in adults, is also implicated in the young population. Arterial stiffness can also lead to increased insulin resistance in adolescents and young adults. Unfortunately, clinical trials aimed at reducing arterial stiffness in adults have not been promising, and clinical trials in young populations are ongoing.
In the new study, the researchers examined whether arterial stiffness increases blood pressure through increased body fat or insulin resistance in a population of normal-weight adolescents. Indeed, clinical trials in the young population have shown that a lifestyle intervention can reduce body fat and insulin resistance. Therefore, if arterial stiffness indirectly increases blood pressure through one of these pathways, it might be clinically relevant to intercept that pathway.
We found that arterial stiffness indirectly increases blood pressure in adolescence through insulin resistance. It is nevertheless surprising that increasing fat mass is not a pathway by which arterial stiffness increases blood pressure in this general adolescent population. Until the results of clinical trials on reducing arterial stiffness in adolescents are available, it may be important for pediatricians and public health experts to focus on encouraging healthy lifestyle choices that reduce insulin resistance and therefore potentially blood pressure. Increasing physical activity, reducing screen time, quitting smoking or vaping, reducing salt and sugar intake, increasing vegetable and fiber intake in diet and optimal daily sleep are healthy lifestyle choices. »
Andrew Agbaje, physician and clinical epidemiologist, University of Eastern Finland.
Dr. Agbaje’s research group (urFIT-CHILD) is supported by research grants from the Jenny and Antti Wihuri Foundation, Finnish Cultural Foundation Central Fund, Finnish Cultural Foundation North Savo Regional Fund, Finnish Cultural Foundation Orion Research sr, Aarne Koskelo Foundation, Antti and Tyyne Soininen Foundation, Paulo Foundation, Yrjö Jahnsson Foundation, Paavo Nurmi Foundation, Finnish Foundation for Cardiovascular Research and Foundation for Research pediatric.
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Journal reference:
Agbaje, AO, et al. (2022) Mediating role of body composition and insulin resistance on the association between arterial stiffness and blood pressure in adolescents: The ALSPAC study. Frontiers of cardiovascular medicine. doi.org/10.3389/fcvm.2022.939125.
