RESUMO
Background and Aims: Blood pressure, body mass index (BMI), and carotid intima-media thickness (CIMT) are well-known independent predictors of cardiovascular disease especially in adulthood. However, there is insufficient evidence regarding the statistical significance of the relationship between childhood CIMT, blood pressure and BMI. This systematic review and meta-analysis was therefore conducted to ascertain the relationship. Methods: This systematic review and meta-analysis was reported in accordance with the PRISMA statement. Three electronic databases were searched, namely EMBASE, MEDLINE and the Cochrane Library. Data were extracted independently by two review authors. Quantitative data were analyzed using Review Manager. Results: The meta-analysis was conducted using a random effects model and standard mean difference. The results of the meta-analysis indicated a statistically significant difference in CIMT of 0.86 (95% CI: 0.41-1.31) between normotensive versus hypertensive children. Again, overweight and moderately obese children had higher CIMT values as compared to normal weight children with a pooled standard mean difference of 0.72 (95% CI: 0.24-1.20) and 2.75 (95% CI: 0.73-4.77) respectively. The pooled standard mean difference of systolic and diastolic blood pressures was found to be 2.44 (95% CI: 1.69-3.19) and 1.28 (95% CI: 0.65-1.92) respectively between normal weight and overweight/obese children. Conclusion: The meta-analysis found a significant difference in CIMT between normotensive and hypertensive children, with overweight and moderately obese children having higher CIMT values. Thus, conducting CIMT screening for obese or overweight children and children with increased blood pressure can provide valuable information about their cardiovascular disease risk.
RESUMO
BACKGROUND: Distribution of coronary artery calcium (CAC) has been determined in different heterogeneous populations in the Multi-Ethnic Study of Atherosclerosis (MESA). Based on findings showing that geography and culture can influence CAC scoring beyond traditional race groups, we determined the distribution of CAC in a homogenous black African population to provide an initial basis for a larger CAC score study in Africa. METHODS AND RESULTS: This is a preliminary study using computed tomography to determine the CAC scores within a black African population who were referred to our center. Other information on patients were recorded through a combination of one-on-one interviews and medical records. A total of 170 patients were involved in our study, including 60.6% males, with an average age of 53.9 ± 9.2 years. The majority (78.8%) had a zero calcium score, with patients within the age group of 55-64 years dominating the non-zero calcium score population. Males were found to have higher calcium levels compared to females, and coronary artery calcification and prevalence steadily rose with the increasing age. However, P-values of 0.328 and <0.001 were observed with distribution of CAC according to gender and age, respectively. CONCLUSION: Findings from this study showed that the distribution of CAC was markedly affected by the age of our study population, which will be more apparent in a larger study.