Decreased aortic elasticity in healthy 11-year-old children exposed to tobacco smoke

Pediatrics. 2009 Feb;123(2):e267-73. doi: 10.1542/peds.2008-2659.


Objective: The goal was to assess the relationship between passive smoking and arterial elasticity in children.

Methods: Healthy 11-year-old children (N = 386) from an atherosclerosis prevention trial (Special Turku Coronary Risk Factor Intervention Project for Children) were studied. Aortic and carotid elasticities were determined by using M-mode ultrasound imaging based on measurements of blood pressure and arterial diameter changes during the cardiac cycle. The aortic stiffness index, Young's elastic modulus, and distensibility and the respective indices for the carotid artery were calculated. Exposure to tobacco smoke was measured by using serum cotinine concentrations, and children were classified into 3 groups, that is, the noncotinine group (n = 220; undetectable cotinine levels), the low-cotinine group (n = 127; cotinine levels of 0.2-1.6 ng/mL), and the top-decile cotinine group (n = 39; cotinine levels of > or =1.7 ng/mL).

Results: Higher cotinine concentrations were associated with increased aortic stiffness index values. An increase in aortic Young's elastic modulus and a decrease in aortic distensibility were observed across the cotinine groups. In multivariate regression models, the cotinine level remained a significant explanatory variable regarding all aortic elasticity indices. Carotid elasticity indices showed no differences across the cotinine groups.

Conclusions: Childhood exposure to tobacco smoke (verified with serum cotinine levels) decreases aortic elastic properties in healthy children.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aorta / physiopathology*
  • Carotid Arteries / physiopathology*
  • Child
  • Cotinine / blood
  • Elasticity
  • Female
  • Humans
  • Male
  • Tobacco Smoke Pollution / adverse effects*


  • Tobacco Smoke Pollution
  • Cotinine