Determinants of vascular phenotype in a large childhood population: the Avon Longitudinal Study of Parents and Children (ALSPAC)

Eur Heart J. 2010 Jun;31(12):1502-10. doi: 10.1093/eurheartj/ehq062. Epub 2010 Apr 25.


Aims: To assess the feasibility and reproducibility of non-invasive vascular assessment in a childhood population setting and identify the determinants of vascular phenotype in early life.

Methods and results: We studied 7557 children (age 9.8-12.3 years) participating in the Avon Longitudinal Study of Parents and Children (ALSPAC). Six research technicians underwent a 5-month training protocol to enable study of brachial artery endothelial function by flow-mediated dilatation (FMD) and arterial stiffness by carotid to radial pulse wave velocity (PWV) and brachial distensibility [distensibility coefficient (DC)]. Reproducibility studies were performed at the beginning, the middle, and the end of the study. A blinded repeat evaluation of a random selection of 3% of the cohort was also undertaken throughout the study. The effect of anthropometric and environmental factors on each measure was examined. Successful measures were obtained in 88, 95, and 87% of the studied children for FMD, PWV, and DC, respectively. The coefficients of variation between technicians for FMD, PWV, and DC were 10.5, 4.6, and 6.6% at the beginning of the study and reached 7.7, 4.1, and 10% at the end. Baseline vessel diameter and gender were important determinants of all the vascular measures, with a small effect of room and skin temperatures on FMD and PWV. Boys consistently had lower FMD and DC and higher PWV measures (P < 0.01 for all).

Conclusion: Reproducible, high-quality assessments of vascular structure and function in children can be made on a large scale in field studies by suitably trained non-specialist operators. This study provides an invaluable resource for assessing the impact of early influences, genetic, and environmental factors on arterial phenotype.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anthropometry
  • Atherosclerosis / genetics
  • Atherosclerosis / physiopathology
  • Atherosclerosis / prevention & control
  • Blood Flow Velocity / genetics
  • Blood Pressure / genetics
  • Brachial Artery / physiology
  • Carotid Arteries / physiology
  • Child
  • Endothelium, Vascular / physiology*
  • Environment
  • Feasibility Studies
  • Female
  • Hemodynamics / genetics*
  • Humans
  • Longitudinal Studies
  • Male
  • Phenotype*
  • Vascular Resistance / genetics
  • Vasodilation / genetics