Effects of Second-Hand Tobacco Smoke Exposure on Vasculature in High-Risk Children Gautam Anand 1, David White 2, Omar Qayum 1, Sarah Burr 2, Ashley Sherman 2, Geetha Raghuveer 2 1 UMKC School of Medicine, 2 Children’s Mercy Hospital (CMH) INTRODUCTION Dyslipidemia and obesity are widely prevalent atherosclerosis-promoting risk factors in children. Atherosclerosis can lead to premature coronary artery disease and stroke. Atherosclerosis decreases vascular distensibility (an artery’s ability to stretch and accommodate cardiac output) by prematurely stiffening the arteries and leads to increased “vascular age,” as measured by higher carotid artery intima-media thickness (CIMT). Second-hand tobacco smoke exposure (SHSE) is a major atherosclerosis-promoting risk factor that affects up to 25% of American children. 1 No studies have examined additive damage from SHSE on vasculature in children with dyslipidemia and other atherosclerosis-promoting risk factors. AIM To measure the effects of household SHSE on the vascular distensibility and CIMT of dyslipidemic children. Design: Prospective, cohort study In PubMed and Google Scholar searches, key terms included “dyslipidemia,” “second-hand smoke exposure,” and “arterial stiffness,” among other terms METHODS (CONTINUED) Sample: 177, 8-15 years old, dyslipidemic children (with or without obesity) from Children’s Mercy Hospital Preventive Cardiology Clinic  Experimental group (46 with SHSE)  Control group (131 without SHSE) Independent variables:  Parent-reported SHSE: individual who smokes, frequency, and location  Urine cotinine (ng/dL): Biological marker of SHSE (>11 ng/dL will be considered SHSE) Dependent variables:  Vascular distensibility: measured with SphygmoCor® XCEL Pulse Wave Velocity (PWV) analyzer (Figure 1)  PWV = distance pulse travels (ΔL) ÷ pulse transit time (Δt )  CIMT: measured over far wall of common carotid artery (Figure 2) POTENTIAL FINDINGS AND LIMITATIONS Study findings may result in further elucidating how childhood SHSE can affect cardiovasculature in young, dyslipidemic, and/or obese children. This age group may be a particularly important target for intervention by encouraging household members to quit smoking or by enforcing stricter smoking bans and regulations. Limitation: subjective nature of questionnaire Current recruitment: N=29  Experimental: n=4  Control: n=25 Plan to complete recruitment by May 2016 RESULTS Figure 1. Carotid- femoral PWV. (Laurent et al., ) Figure 2. CIMT, measured along far wall of common carotid artery using Q lab software. CIMT is outlined by parallel green lines. CIMT Common carotid lumen Carotid bulb SIGNIFICANCE METHODS Credits: Ms. Jennifer Marshall and Ms. Jennifer Panuco, Heart Center Research and Quality, CMH References: 1.Oberg M, Jaakkola MS, et al. Worldwide burden of disease from exposure to second- hand smoke: a retrospective analysis of data from 192 countries. Lancet, 2011;377: Laurent S, Cockcroft J, et al. Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J, 2006; 27: