In the young population, arterial stiffness, an emerging risk factor for hypertension, indirectly increases blood pressure through increased insulin resistance, but not through increased body fat, concludes a paper published in Frontiers in Cardiovascular Medicine.
There is a global effort aimed at screening, identification and early diagnosis of hypertension to prevent this “silent killer disease” and its sequelae from early life. There are still gaps in knowledge about the pathways by which blood pressure rises even in normal-weight populations that 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 causal risk factor for hypertension in adults, is also involved in the young population. Arterial stiffness can also lead to increased insulin resistance in adolescents and young adults. Unfortunately, clinical trials to reduce 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 largely normal adolescent population. This is because clinical trials in young people have shown that lifestyle intervention could reduce body fat and insulin resistance. Therefore, if arterial stiffness indirectly increases blood pressure through any of these pathways, it might be clinically relevant to intercept this pathway.
We found that arterial stiffness indirectly increased blood pressure in adolescence via the insulin resistance pathway. However, it is surprising that increased body fat was not a pathway by which arterial stiffness increased blood pressure in this general adolescent population. Until clinical trial results 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, to both, reduce blood pressure. Increasing physical activity, reducing screen time, quitting smoking or vaping, reducing salt and sugar intake, increasing the portion of vegetables and fiber in the diet and getting optimal daily sleep are lifestyle choices healthy”.
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, the Central Fund of the Finnish Cultural Foundation, the Regional Fund of the Finnish Cultural Foundation North Savo, the Orion Research Foundation sr, the Aarne Koskelo Foundation, the Antti and Tyyne Soininen Foundation, the Paulo Foundation, the Yrjö Jahnsson Foundation, the Paavo Nurmi Foundation, the Finnish Cardiovascular Research Foundation and the Pediatric Research Foundation.
Source:
University of Eastern Finland
Journal reference:
Agbaje, AO, et al. (2022) Mediating role of body composition and insulin resistance in the association of arterial stiffness with blood pressure among adolescents: the ALSPAC study. Frontiers in Cardiovascular Medicine. doi.org/10.3389/fcvm.2022.939125.