Abstract 024: The Timing of Cardiovascular Health Decline and Its Association With Subclinical Atherosclerosis in Adulthood

Abstract

Introduction: Declines in CVH beginning as early as childhood have been linked to development of subclinical atherosclerosis and CVD in adulthood; however, less is known about the timing and sequence. The objective of this study was to determine patterns for the loss of the health factors that comprise CVH and the associations with cIMT. Methods: We pooled data from five childhood/young adult cardiovascular cohorts including BHS, CARDIA, Young Finns, Project HB!, and STRIP. Available data allowed analysis of 4 of the 7 metrics that define CVH: BMI, blood pressure, total cholesterol, and blood glucose, categorized as ideal or non-ideal. We built a multi-trajectory model which fitted trajectory groups based on the simultaneous modeling of the loss of ideal CVH (defined as the probability of being ideal for a given health factor dropping below 50%), from childhood (ages 0-19) through early adulthood (ages 20-39) to middle adulthood (ages 40-59). Logistic regression was used to examine association of the trajectories and high cIMT. Results: There were 9,388 individuals included (55% female, 66% white), and 5 distinct trajectory groups were formed (Figure). As compared to those who maintained ideal levels of all four health factors, those who had a childhood loss of a single ideal health factor were about two times as likely to have high cIMT (cholesterol OR: 1.99; 95% CI 1.49-2.65; BMI OR: 1.91; 95% CI 1.45-2.53), while those with loss of more than one ideal health factors in childhood were 2.89 times more likely to have high cIMT (95% CI 2.21-3.78). The loss of ideal BMI and cholesterol during early adulthood was also associated with a higher likelihood of high cIMT than when ideal levels were retained to this age (OR: 1.47; 95% CI 1.10-1.97). Conclusions: Loss of multiple CVH factors in childhood was associated with the highest probability of developing subclinical atherosclerosis compared with retention of ideal levels into middle adulthood. These data add evidence of the importance of preserving ideal CVH beginning in childhood.