Published online January 2, 2008
PEDIATRICS Vol. 121 Supplement January 2008, pp. S94-S95 (doi:10.1542/peds.2007-2022O)
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ALLERGOLOGY


EXPOSURE TO TOBACCO SMOKE DECREASES ELASTICITY OF THE AORTA IN CHILDREN

Katariina Kallioa, Eero Jokinenb, Olli Simellc and Olli Raitakarid

a Research Center of Applied and Preventive Cardiovascular Medicine
c Departments of Pediatrics
d Clinical Physiology, University of Turku, Turku, Finland
b Department of Pediatrics, University of Helsinki, Helsinki, Finland

ABSTRACT

INTRODUCTION: Attenuated arterial elasticity is one of the earliest markers of atherosclerosis.

OBJECTIVE: Our aim was to investigate the relationship of passive smoking and elastic properties of the aorta.

METHODS: We studied 11-year-old healthy children (n = 386) from the randomized, prospective atherosclerosis prevention trial (STRIP). Aortic elasticity was analyzed by using M-mode ultrasound imaging on the basis of the measurement of blood pressure and arterial diameter changes during diastole and systole. Aortic compliance (AC) and aortic stiffness index (SI) were calculated. Exposure to tobacco smoke was measured by using serum cotinine concentration, which was analyzed with gas chromatography.

RESULTS: Cotinine concentrations ranged from nondetectable (detection limit: 0.16 ng/mL) to 6.8 ng/mL. Cotinine values and aortic elasticity measures were similar between genders. Children were classified into 3 groups according to their cotinine concentration: the top-decile cotinine group (n = 39), the nondetectable cotinine group (n = 220), and the low cotinine group (n = 127). Conventional atherosclerosis risk factors were similar between the 3 cotinine groups. A decreasing trend in AC (P = .041) and an increasing trend in SI (P = .006) was observed across the cotinine groups with an increasing level of tobacco smoke exposure. In addition, systolic and diastolic blood pressure and BMI were independent predictors of the aortic elasticity indices. In multivariable models, cotinine level (P = .020) and systolic blood pressure (P < .001) were inversely associated with AC and directly related to SI (cotinine level, P = .005; systolic blood pressure, P = .0003).

CONCLUSIONS: These data suggest that passive smoking is associated with decreased aortic elasticity in children, indicating early arterial changes.

Submitted by Katariina Kallio