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Ideal Cardiovascular Health in Childhood and Cardiometabolic Outcomes in Adulthood: The Cardiovascular Risk in Young Finns Study
Study Questions:
Are cardiovascular healthy behaviors and factors in childhood associated with cardiometabolic outcomes in adulthood?
Methods:
Data from the Cardiovascular Risk in Young Finns Study were used for the present analysis. A sample of participants ages 12-18 years were followed for 21 years from baseline (starting in 1986, when glucose values were first measured). Health factors measured included fasting lipid and glucose levels. Blood pressure, body mass index (BMI), food frequency, self-reported physical activity, and smoking habits were also assessed at baseline (1986) and follow-up (2007). Cardiometabolic outcomes included carotid artery intima-media thickness, diabetes, metabolic syndrome, hypertension, or dyslipidemia.
Results:
Of all participants enrolled in 1986, 560 were lost to follow-up, leaving 856 participants followed through 2007. Those lost to follow-up were more likely to be males and younger. On average, participants met 3.5 of all 7 ideal metrics. No participant met all 7 ideal metrics in childhood. In childhood, the ideal cardiovascular health metrics were met by 85.6% of the participants for BMI, 6.9% for physical activity, 24.3% for healthy diet score, 22.4% for smoking status, 82.2% for blood pressure, 97.4% for glucose level, and 33.2% for total cholesterol level. After adjustment for age and sex, the number of ideal cardiovascular health metrics present in childhood was associated with reduced risk of hypertension (odds ratio [95% confidence interval] 0.66 [0.52-0.85], p < 0.001), metabolic syndrome (0.66 [0.52-0.77], p < 0.001), high low-density lipoprotein cholesterol (0.66 [0.52-0.85], p < 0.001), and high-risk carotid artery intima-media thickness (0.75 [0.60-0.94], p < 0.01) in adulthood. Further adjustment for socioeconomic status did not significantly alter these associations.
Conclusions:
The investigators concluded that obtaining healthy cardiometabolic metrics is associated with cardiometabolic health in adulthood.
Perspective:
This longitudinal study highlights the importance of childhood health in the prevention of cardiovascular disease and diabetes in adulthood. Efforts to improve primary prevention must start in childhood years and include lifestyle interventions.
Keywords: Cholesterol, Dyslipidemias, Body Mass Index, Cholesterol, LDL, Cholesterol, HDL, Diet, Hypertension, Health Behavior, Glucose
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