Pulse pressure in youth and carotid intima-media thickness in adulthood: the cardiovascular risk in young Finns study.

BACKGROUND AND PURPOSE Large pulse pressure associates with atherosclerosis, but it is unclear if it contributes to the development of atherosclerosis or if atherosclerosis leads to pulse pressure widening. We examined whether exposure to large pulse pressure in childhood predicts carotid artery intima-media thickness in adulthood. METHODS Carotid intima-media thickness was measured in 2146 adults in the Cardiovascular Risk in Young Finns Study. These subjects have blood pressure data available dating back to their childhood (baseline in 1980, ages 3 to 18 years). RESULTS Baseline pulse pressure measured in adolescence was significantly related to carotid intima-media thickness measured in adulthood 21 years later (r=0.123, P<0.0001). The relation remained significant (P=0.0029) in models adjusted for age, sex, adolescent mean arterial pressure, adult systolic pressure, adult pulse pressure, body mass index, smoking, physical activity, and carotid artery diameter. Each 10 mm Hg increment in pulse pressure was associated with a 0.008-mm (95% CI, 0.003 to 0.013 mm) increase in carotid intima-media thickness. CONCLUSIONS Exposure to wide pulse pressure in adolescence may induce changes that contribute to carotid artery intima-media thickening.