Objective: Ideal cardiovascular health (ICH) among adolescents is defined as the optimal levels of three CV risk factors (SBP/DBP, fasting glucose, total cholesterol) and four behaviours (BMI, not smoking, healthy diet, physical activity)¹. We investigated the burden of ICH among Italian adolescents, and its association with arterial stiffness (carotid-femoral pulse wave velocity,cfPWV).

Methods: 307 healthy subjects (mean age 17±2 years, 55% men) attending the High School at Terni, Italy, were evaluated. Physical activity, dietary and smoking were assessed through self-reported questionnaires. Sodium consumption was estimated by second fasting urine. Smoking was confirmed by exhaled carbon-oxyde. cfPWV was evaluated by arterial tonometry (SphygmoCor, subtracted distance). For each ICH metric, a score of 2 was also assigned if levels were ideal, 1 if intermediate, and 0 if poor.

Results: None had all 7 ICH metrics the majority (76%) had 4 or more ICH metrics. An inverse linear trend in cfPWV was observed over the number of ICH (p for linear trend <0.01). According to ICH score, after adjustment for age and sex, subjects in the lower tertile, compared to upper tertile, showed higher values of cf-PWV (5.1±1.3 m/s vs 4.6±1.8 m/s, p<0.01), which remained significant after further adjustment for mean BP and other confounding factors (p=0.02).

Conclusions: ICH is relatively uncommon among Italian adolescents, and is inversely related to cf-PWV in females. The potential adverse effects of CV risk factors and unhealthy behaviours on arterial stiffness, an early marker of vascular damage, begins to develop at an early stage of lifespan.