Abstract 16640: Association of Cardiovascular Health in Young Adulthood with Left Ventricular Structure and Function Later in Life: The Coronary Artery Risk Development in Young Adults (Cardia) Study

Abstract

BACKGROUND: The American Heart Association defines cardiovascular health (CVH) based on seven metrics. We sought to determine the association between CVH in young adulthood and left ventricular (LV) structure and function later in life. METHODS: CARDIA recruited men and women age 18-30 years of white and black race; we included all participants (ppts) who underwent echocardiography at year 25. We defined CVH at the year 0 examination in ppts based on the following metrics: systolic blood pressure, total cholesterol, fasting blood glucose, body mass index, smoking status, diet, and physical activity. We assigned 2, 1, or 0 points to each component for ideal, intermediate, and poor levels of each component (i.e., a score of 14 indicates overall ideal CVH). We then stratified ppts into the following CVH groups based on point score: ≤ 8 (‘low’), 9-11 (‘intermediate’), and 12-14 (‘high’). We then used linear and logistic regression models adjusted for age, race, sex, and education to determine the association between stratum of CVH at year 0 and echocardiographic measurements at year 25. LV systolic dysfunction was defined as ejection fraction < 55%. RESULTS: The distribution of CVH at year 0 was as follows: low, N = 264 (9%); intermediate, N = 1315 (47%); and high, N = 1224 (44%). In ppts with high CVH at year 0, the multivariable-adjusted odds ratio (OR) for LV hypertrophy at year 25 was 0.46 (95% CI, 0.35-0.61, P < 0.001), compared to ppts with low CVH. Ppts with high CVH at year 0 also had lower risk for LV systolic dysfunction at year 25, although this was of borderline significance (OR 0.80, 0.55-1.16, P = 0.09). As shown in the Table, ppts with high and intermediate CVH had significantly lower LV end-diastolic volume, left atrial diameter, and LV posterior wall thickness. CONCLUSION: Individuals with high CVH in young adulthood are more likely to have favorable LV structure and function later in life. These results provide further evidence for the benefits of a healthy lifestyle at an early age.