Abstract
Background
Subclinical cardiovascular risks of secondhand smoke (SHS) exposure among children and adolescents remains insufficiently described.
Methods
This was a cross-sectional study of 298 children and adolescents (48.0% male, body mass index: 27.0 ± 8.9 kg/m2), including 49 self-reported cases with SHS. Arterial elasticity and stiffness (distensibility, compliance, incremental elastic modulus [IEM]) were obtained via ultrasound imaging in the abdominal aorta, brachial, and carotid arteries. A one-way analysis of variance compared differences between groups, and multiple linear regression adjusted for covariates.
Results
SHS was associated with lower abdominal aorta diameter distensibility (aDD) (13.4 ± 3.6% vs. 16.0 ± 5.2%, p = 0.009) and abdominal aorta cross-sectional distensibility (aCSD) (28.8 ± 8.3% vs. 35.1 ± 12.2%, p = 0.009), as well as higher abdominal aorta IEM (aIEM) (1241 ± 794 vs. 935 ± 388 mmHg, p = 0.001). After adjustment for covariates, aDD (p = 0.047), aCSD (p = 0.040), and aIEM (p = 0.017) remained significant; this significance persisted with the additional adjustment of percent body fat. Measures of brachial and carotid compliance and distensibility were not associated with SHS.
Conclusions
SHS was associated with abdominal aorta stiffness; the majority of vascular measures within the brachial and carotid artery remained unaffected following adjustment for covariates, including hypertension and adiposity. SHS may predispose individuals to increased abdominal aorta stiffness, an artery previously reported to exhibit increased susceptibility to atherosclerosis.
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Acknowledgements
Funding for this project was provided by the National Heart, Lung, and Blood Institute (R01HL110957, awarded to A.S.K.).
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No payment was received to produce this manuscript. M.M.H. drafted the manuscript. M.M.H. and J.R.R. developed the aims and hypothesis. A.S.K. and J.R.R. provided the funding, and contributed to the conception, design, and analysis and interpretation of the data. N.G.E. was involved with the acquisition of the data. K.D.R., A.S.K., D.R.D., N.G.E., and J.R.R. provided subject matter expertise and a critical review of the manuscript. All authors have seen this manuscript, and give approval of this version to be published.
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Dr. Kelly serves as a consultant for Novo Nordisk, WW, and Vivus Pharmaceuticals, but does not receive personal or professional income for these activities; he also receives research support (drug/placebo) from Astra Zeneca Pharmaceuticals for an NIDDK-funded clinical trial. Dr. Dengel serves as a paid consultant for Hologic Inc. Dr. Ryder receives research support (drug/placebo) from Boheringer Ingelheim for a clinical trial. The other authors declare no competing interests.
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Harbin, M.M., Kelly, A.S., Dengel, D.R. et al. Relation of secondhand smoke exposure to vascular phenotypes in children and adolescents. Pediatr Res 87, 760–766 (2020). https://doi.org/10.1038/s41390-019-0627-x
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DOI: https://doi.org/10.1038/s41390-019-0627-x
