Carotid extramedial thickness is associated with local arterial stiffness in children

Tommy Y. Cai, Tim R. Sullivan, Julian G. Ayer, Jason A. Harmer, Stephen R. Leeder, Brett G. Toelle, Guy B. Marks, David S. Celermajer, Michael R. Skilton, Anna L. Hansell, Nectarios Rose, Christine T. Cowie, Elena G. Belousova, Ioannis Bakolis, Kitty Ng, Catarina Almqvist, Rosario D. Ampon, Tessa Bird, Bronwyn K. Brew, Warwick J. BrittonChristopher T. Cowell, Daniele Crisafulli, Sally Criss, Stella Davis, Wafaa Nabil Ezz, Samantha Forbes, Frances L. Garden, Andrew S. Kemp, Natalia Knezevic, William Krause, Craig M Mellis, Seema Mihrshahi, Mark Neumann, Jennifer K. Peat, Andres Quinones-Lucio, Anne Tattam, Euan R. Tovey, Carl H. Vanlaar, Nicola Vukasin, Craig Wainwright, Karen L. Webb, Christina Weber-Chrysochoou, Ann J. Woolcock, Jie Zhou

Research output: Contribution to journalArticlepeer-review


Objectives: Experimental evidence suggests that structural changes to the arterial adventitia may be a key vascular determinant of early arterial stiffening, although this has not been directly studied. Accordingly,we hypothesized that in young children, in whom this relationship would not be altered by atheroma, carotid extramedial thickness (EMT), a measure that incorporates the thickness of the arterial adventitia, perivascular tissues and the internal jugular venous wall, would be associated with localized arterial stiffness of the same arterial region.

Methods: We studied 248 healthy prepubescent children (aged 8 years). Carotid diameter and carotid EMT were measured by high-resolution ultrasound. Carotid blood pressure was derived from brachial blood pressure and carotid tonometry. Three measures of localized arterial stiffness (β stiffness index, distensibility coefficient and incremental modulus of elasticity) were calculated for the common carotid artery. Results were adjusted for heart rate and DBP, two important hemodynamic determinants of arterial stiffness.

Results: Carotid EMT was associated with all three measures of arterial stiffness (β stiffness index: standardized β = 0.121, P = 0.03;distensibility coefficient: standardized β = -0.121, P = 0.05; incremental modulus of elasticity: standardized β = 0.140, P = 0.02). These associations remained significant after adjustment for potential confounders such as sex,height, waist circumference, BMI and body surface area.

Conclusion: Carotid EMT is associated with the stiffness of the same arterial segment in children, suggesting that the arterial adventitia may be involved in early changes in arterial stiffness during childhood.


Original languageEnglish
Pages (from-to)109-115
Number of pages7
JournalJournal of Hypertension
Issue number1
Publication statusPublished - 1 Jan 2016
Externally publishedYes


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