Abstract 11510: Associations of Cardiovascular Health in Young Adulthood with Long-Term Blood Pressure Trajectories: Coronary Artery Risk Development in Young Adults (CARDIA) Study

Abstract

Introduction: Cardiovascular health (CVH) in young adulthood (YA) has been associated with cardiovascular outcomes in older age. However, little is known about the relationship between YA CVH and mid-life BP trajectories. Methods: CVH (defined by 6 of AHA’s 7 metrics, excluding BP) was measured twice in YA and defined as poor, intermediate, and ideal for each metric, scored as 0, 1, or 2 points respectively, then summed as a composite CVH score (range 0 to 12). Categorical CVH status was defined as ≥10 points = high, 6-9 = moderate, 0-5 = low. Latent-class modeling (SAS Proc Traj) was used to identify trajectories of mid-BP (mean of SBP and DBP) from ages 35 to 55 years. Multinomial logistic regression was used to estimate the association of YA CVH status with mid-life BP trajectory group membership. Results: There were 3,358 CARDIA participants (56% female, 46% Black; mean age 25 years) in YA with follow-up data for BP trajectories. We observed 3 BP trajectory groups, labeled as low, middle, and higher (Figure). A 1-point higher CVH score in YA was associated with adjusted odds ratios (aORs) of 0.84 (95% CI, 0.80-0.89) for being in the middle and 0.73 (0.67-0.79) for being in the higher mid-life BP trajectory groups. Compared with high CVH status at baseline, those with low and moderate CVH were significantly more likely to be in the middle and higher BP trajectory groups (Table). Among the CVH metrics, only BMI was significantly associated with BP trajectory group. Conclusions: Moderate or low CVH status in YA is associated with elevated mid-life BP trajectory. These data suggest that early life CVH status, and particularly BMI, may be important to manage for primordial prevention of hypertension.