Abstract 005: Childhood Risk Factors and Cardiovascular Disease Outcomes in Adulthood. Preliminary Findings From the International Childhood Cardiovascular Cohort (i3C) Consortium

Abstract

Background: Atherosclerosis develops silently for decades before clinical cardiovascular disease (cCVD) occurs. Longitudinally, childhood risk factors predict adult pre-clinical atherosclerosis (carotid artery plaques, coronary artery calcification). There is currently no evidence directly linking childhood risk factors to cCVD. Methods: Using data from the i3C Consortium, consisting of five cohorts from the United States, one from Australia and one from Finland, we linked youth risk factors to adult cCVD. cCVD events were ascertained by re-contacting the participants in the US and Australia, then obtaining and medically adjudicating hospital records; and using the Finnish national health registry. Of 16,964 of these adult participants (mean age 49 years, range 24-67 years) who had been examined during ages 3-19 years, 201 people with any cCVD event (coronary artery, cerebrovascular, and peripheral artery disease, 70%, 25%, and 5% of events, respectively) have so far been ascertained. Analysis of deaths is in process. The associations between each youth risk variable and adult cCVD were examined in Cox proportional hazard models. Each model was additionally adjusted for childhood age, age at followup, sex and cohort/race. Continuous youth variables were z-scored for each participant’s last repeated measure during childhood. Results: Youth body mass index (BMI), serum total cholesterol (TC) and triglycerides, and systolic blood pressure were (all P <0.0001) positively associated with adult cCVD events. Regular smoking in youth was associated with a nearly 50% increased risk of adult cCVD (P=0.08). BMI and TC remained significant in the simultaneous risk factor model. The adjudication pipeline suggests that over 500 hospitalized cCVD events will be found when adjudication is complete. Regression using the full set of imputed events yielded similar findings. Conclusion: These international data find that exposure to CVD risk factors in youth predicts adult cCVD with implications for primordial CVD prevention.