Ideal Cardiovascular Health in Adolescence: Effect of Lifestyle Intervention and Association with Vascular Intima-Media Thickness and Elasticity (the STRIP Study)
Background—In the STRIP study, repeated dietary counseling introduced in infancy and maintained until age 20 has led to lower intakes of saturated fat and serum LDL-cholesterol. In this study, we examined prospectively the intervention effects on the ideal cardiovascular health concept recently described by the AHA. Additionally, we investigated association of the concept with vascular intima-media thickness (IMT) and elasticity in adolescence.
Methods and Results—In adolescents participating in the longitudinal, randomized atherosclerosis prevention STRIP study, complete data on ideal cardiovascular health metrics were available at age 15 (n=394), 17 (n=376) and 19 (n=298). Aortic IMT and elasticity were measured with ultrasonography at same ages. None of the adolescents had all 7 ideal cardiovascular health metrics. At least 5 ideal metrics was found in 60.2%, 45.5% and 34.2% of the adolescents at age 15, 17 and 19, respectively. Adolescents in the control group had an increased risk of low ideal cardiovascular health (≤3 metrics) compared with the intervention adolescents (RR=1.35, 95%CI=1.04-1.77). Number of the ideal cardiovascular health metrics was inversely associated with aortic IMT (p<0.0001) and directly with elasticity (p=0.045). Risk of having high IMT (>85th percentile) was nearly two fold in adolescents with low number of the metrics (≤3) compared with those with a higher score (RR=1.78, 95%CI=1.31-2.43).
Conclusions—Ideal cardiovascular health as determined by the AHA can be promoted in adolescents. The ideal cardiovascular health concept is beneficially associated with vascular health already in adolescence supporting the relevance of targeting these metrics as part of primordial prevention.
Clinical Trial Registration Information—ClinicalTrials.gov, STRIP19902010. Unique Identifier: NCT00223600.
- Received December 21, 2012.
- Revision received April 4, 2013.
- Accepted April 10, 2013.