PRONOUNCED POSTOCCLUSIVE REACTIVE HYPERAEMIA IN CHILDREN COMPARED TO ADULTS

Abstract

The initiation and development of vascular disease might start already in childhood. Functional vascular disturbances should be possible to find in many progressive disorders as e.g. diabetes mellitus before structural lesions develop. Such findings could suggest clues for understanding and be suitable for studies of pathogenetic mechanisms. Postocclusive reactive hyperaemia is a coomonly used physiological test of vascular function. We have earlier shown that this response is readily detected by a transcutaneous oxygen electrode used at 37°C (SJCLI 1981; 41: 641, Lancet 1981; i: 1287). The method has the advantage of being non-invasive and measures changes occuring in defined skin vessel regions.

Results: A statistically significant difference in the postischaemic peak tcPO₂ was found between healthy children and adults. Thus 34 healthy children aged 5-18 showed a value of 4.0±1.0 kPa compared with 2.6±1.0 kPa for 67 healthy adults aged 22-60 years (p < 0.001). A corrolation coefficient between the log. age and the postischaemic peak of -0.63 (p < 0.01) was found. In the group of children no significant sex difference in the postocclusive peak tcPO₂ was observed (boys 3.8±1.2 and girls 4.1±0.8 kPa respectively; 0.05 <p< 0.1), whereas among the 67 healthy adults, females (n=30) showed significantly higher postischaemic peak tcPO₂ values than males (3.2±0.9 and 2.1±0.8 kPa respectively; < 0.001).

Conclusions: A significant decrease in vascular response to tissue ischaemia occurs already during childhood. Studies on risk factors for development of vascular disease should therefore start already in children.

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