Introduction
Childhood declines in cardiovascular health have been linked to the development of
subclinical atherosclerosis; however, less is known about the timing and sequence
of the decline of the specific cardiovascular health components. The study objective
is to identify the patterns of decline and associations with adulthood subclinical
atherosclerosis.
Methods
Data were pooled from 5 cardiovascular cohorts. Clinical components of cardiovascular
health (BMI, blood pressure, cholesterol, and blood glucose) were categorized as ideal
or nonideal using American Heart Association definitions. Multitrajectory models simultaneously
fitted the probability ideal for each factor. Adjusted associations between trajectory
groups and carotid intima-media thickness were modeled. Data were pooled from December
1, 2015 to June 1, 2019; statistical analysis occurred between June 1, 2019 and June
1, 2020.
Results
This study included 9,388 individuals (55% female, 66% White). A total of 5 distinct
trajectory groups were created: 1 maintained the ideal levels of all the 4 health
factors, 2 had risk onset of a single factor in childhood, 1 had risk onset of multiple
factors in childhood, and 1 had risk onset in adulthood. Those with childhood multiple
risk onset had 8.1% higher carotid intima-media thickness (95% CI=0.067, 0.095) than
those in the ideal group, childhood cholesterol risk onset had 5.9% higher carotid
intima-media thickness (95% CI=0.045, 0.072), childhood BMI risk onset had 5.5% higher
carotid intima-media thickness (95% CI=0.041, 0.069), and early adulthood multiple
risk onset had 2.7% higher carotid intima-media thickness (95% CI=0.013, 0.041).
Conclusions
Those who lost the ideal status of cardiovascular health in childhood and early adulthood
had more subclinical atherosclerosis than those who retained the ideal cardiovascular
health across the life course, underscoring the importance of preserving the ideal
cardiovascular health beginning in childhood and continued into adulthood.
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Published online: July 05, 2021
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© 2021 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
