A Prospective Study of Positive Early-Life Psychosocial Factors and Favorable Cardiovascular Risk in Adulthood

Study Questions:

Are childhood factors associated with favorable cardiovascular risk in adulthood?


Data for this study were from the Collaborative Perinatal Project, a national cohort initiated in 1959 to 1966, comprising pregnant women and their offspring who were regularly assessed from birth to 7 years. The New England Family Study is a set of follow-up studies of the now adult offspring from the New England sites. The present participants include New England Family Study participants involved in two adult follow-up studies: first, in the Brown-Harvard Transdisciplinary Tobacco Use Research Center and, subsequently, in the EdHealth study that included 618 Transdisciplinary Tobacco Use Research Center participants, selected with preference for racial/ethnic minorities and those with low and high levels of education. Three specific factors assessed at age 7 years were examined. These included attention regulation (ability to stay focused), cognitive ability, and positive home environment. Favorable cardiovascular risk was defined as meeting the following criteria in midlife: systolic blood pressure ≤120 mm Hg, diastolic blood pressure ≤80 mm Hg, not taking antihypertensive medication, total cholesterol <200 mg/dl, not taking cholesterol-lowering medication, body mass index <25 kg/m2, not having diabetes mellitus, and nonsmoker. Favorable cardiovascular risk was dichotomized according to whether or not participants met all criteria (yes/no).


A total of 415 adults were included in this cohort; of these adults, 10.6% had favorable cardiovascular risk in midlife. After adjusting for demographics and childhood cardiovascular health, each 1-unit increase in childhood attention regulation, cognitive ability, and positive home environment was associated with 2.4 (95% confidence interval [CI], 1.1-4.7), 1.8 (95% CI, 1.1-2.9), and 1.3 (95% CI, 1.1-1.6) higher respective odds of having midlife favorable cardiovascular risk. The association with childhood attention regulation was maintained when accounting for adulthood factors; education and diet in part explained the associations with childhood cognitive ability and home environment. The effect of each attribute was additive, as those with high levels of each childhood factor had 4.3 higher odds (95% CI, 1.01-18.2) of midlife favorable cardiovascular risk in comparison with those low in all factors.


The investigators concluded that positive childhood psychosocial factors may promote healthy adult cardiovascular functioning. Primordial prevention efforts aimed at preventing the development of cardiovascular risk should consider building on childhood psychosocial resources.


These data build on prior evidence that suggest our lifestyle patterns in childhood may significantly influence our cardiovascular risk factor status as adults. If we are to reduce the morbidity and mortality of cardiovascular disease in the United States and globally, we need to start earlier and understand the influence of childhood life factors in relation to cardiovascular disease risk.

Clinical Topics: Prevention, Diet

Keywords: Adult Children, Cognition, Life Style, Blood Pressure, Risk Factors, New England, Body Mass Index, Attention, Cardiovascular Diseases, Tobacco Use, Diet, United States

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