Ideal Cardiovascular Health in Childhood and Cardiometabolic Outcomes in Adulthood

TLDR

The American Heart Association introduced the concept of ideal cardiovascular health, defined by both ideal health behaviors and factors, and established metrics to monitor it over time. This study examined whether ideal cardiovascular health in childhood predicts cardiometabolic outcomes in adulthood, a relationship previously unreported. Using the Cardiovascular Risk in Young Finns Study, 856 children aged 12–18 were followed for 21 years to assess childhood health behaviors/factors and adult cardiometabolic outcomes. Higher numbers of ideal cardiovascular health metrics in childhood were associated with lower odds of hypertension, metabolic syndrome, high LDL, and increased carotid intima‑media thickness in adulthood, independent of age, sex, and socioeconomic status.

Abstract

Background— The American Heart Association (AHA) defined a new concept, cardiovascular health, and determined metrics needed to monitor it over time as part of its 2020 Impact Goal definition. Ideal cardiovascular health is defined by the presence of both ideal health behaviors and ideal health factors. The applicability of this concept to a cohort of children and its relationship with cardiometabolic outcomes in adulthood has not been reported. Methods and Results— The sample comprised 856 participants aged 12 to 18 years (mean age 15.0 years) from the Cardiovascular Risk in Young Finns Study cohort. Participants were followed up for 21 years since baseline (1986) and had data available concerning health factors and behaviors in childhood and cardiometabolic outcomes in adulthood (2007). The number of ideal cardiovascular health metrics present in childhood was associated with reduced risk of hypertension (odds ratio [95% confidence interval] 0.66 [0.52–0.85], P <0.001), metabolic syndrome (0.66 [0.52–0.77], P <0.001), high low-density lipoprotein cholesterol (0.66 [0.52–0.85], P =0.001), and high-risk carotid artery intima-media thickness (0.75 [0.60–0.94], P =0.01) in adulthood. All analyses were age and sex adjusted, and the results were not altered after additional adjustment with socioeconomic status. Conclusions— The number of ideal cardiovascular health metrics present in childhood predicts subsequent cardiometabolic health in adulthood. Our findings suggest that pursuit of ideal cardiovascular health in childhood is important to prevent cardiometabolic outcomes in adulthood.