Abstract 17479: Early Life Cardiovascular Health Trajectories and Their Association With Subclinical Atherosclerosis
Introduction: Among adults, cardiovascular health (CVH) has been associated with carotid intima-media thickness (cIMT), a measure of subclinical atherosclerosis. Little is known about whether early-life trajectories in CVH are associated with cIMT in middle age.
Methods: We pooled data from 3 prospective, childhood/early adulthood cohorts - Coronary Artery Risk Development in Young Adults (CARDIA), Bogalusa, and Young Finns Studies. Four CVH factors—BP, BMI, cholesterol, glucose—were categorized as poor, intermediate and ideal levels, scored as 0, 1 or 2 respectively, then summed as a clinical CVH score, ranging from 0 to 8 (higher = better CVH). Group-based modeling techniques (PROC TRAJ) identified 5 trajectories in this clinical score from childhood through middle age. cIMT was measured in middle age at an average age of 43 yrs. High cIMT was defined as a measurement at or above a cohort-, race-, gender-, and age-specific 90th percentile cut point. The association between CVH trajectory and cIMT was modeled using both linear and logistic regression (for the outcome of high cIMT) adjusted for cohort, age, gender, race, and baseline CVH score.
Results: Among 6,308 participants (57% female, 29% African American) those in the High-Stable CVH trajectory group had significantly lower adjusted cIMT vs. trajectory groups with declining scores (0.62 mm vs 0.65-0.69 mm; p-value <0.01). The prevalence of high cIMT was lowest among the High-Stable group (5.7%) and highest in the Intermediate-Rapidly Declining group (18%). As compared to the High-Stable group, all other trajectories had greater odds of high cIMT than the High-Stable Group (table) independent of demographics or baseline CVH scores.
Conclusion: Declining trajectories of clinical CVH scores from childhood through adulthood increases risk of high cIMT in middle age independent of baseline CVH scores. Promoting and preserving ideal CVH from early in life onwards appears critical to reducing subsequent CVD risk.
Author Disclosures: N.B. Allen: None. A. Krefman: None. D. Labarthe: None. P. Greenland: None. M. Juonala: None. M. Kähönen: None. T. Lehtimäki: None. O. Raitakari: None. S. Day: None. L. Bazzano: None. C. Alonso: None. L. Van Horn: None. L. Liu: None. M. Gillman: None. L. Webber: None. K. Pahkala: None. A. Kylliäinen: None. D. Lloyd Jones: None.
- © 2016 by American Heart Association, Inc.