Abstract 121: Longitudinal Associations of Childhood Hemodynamic and Metabolic Traits to Adult Aortic Stiffness Vary by Race: The Bogalusa Heart Study

Abstract

Background: Aortic stiffness predicts future hypertension and cardiovascular disease (CVD) events. CVD predictors like metabolic traits and arterial stiffness vary by race. We hypothesized that in longitudinal analyses, metabolic traits since childhood would be associated with adulthood aortic stiffness, and that these associations vary by race in the biracial (black vs. white) Bogalusa Heart Study cohort. Methods: Included participants had ultrasound as young adults for aorta-femoral pulse wave velocity (afPWV) and at least three Study visits over the life course. Sampled participants (n=1081) were 24-44 years old, 31% black, 57% female, and mean follow-up was 27 years. Demographic, anthropometric, blood pressure, lipid, glucose and tobacco exposure data were extracted from each visit. Given variable visit intervals and numbers, growth mixed models were used to compute total area under the curve for risk factors on the primary outcome of interest, young adult afPWV. Childhood versus cumulative risk factors to afPWV associations were examined with multivariable adjusted linear regression. Significant race by risk factor interaction terms (p<0.001) led to race-specific reporting. Results: Adult afPWV was higher in black (5.4+/-1.2 m/s) than white (5.2+/-1.1 m/s) participants (p=0.01). Overall, afPWV was associated with childhood and cumulative low density lipoprotein cholesterol (LDL-C, β=0.13; p<0.001 and β=0.08; p<0.01, respectively) and mean arterial pressure (MAP, β=0.1; p=0.02 and β=0.18; p<0.001) and cumulative glucose (β=0.13; p<0.001). For blacks and whites, higher afPWV was associated with childhood LDL-C (β=0.17; p<0.01 and β=0.1; p<0.01) and cumulative glucose (β=0.14; p=0.02 and β=0.15; p<0.001). Only in whites were childhood and cumulative MAP (β=0.08; p=0.04 and β=0.22; p<0.001) and cumulative LDL-C (β=0.1; p<0.01) associated. Conclusions: Young adult aortic stiffness was associated with childhood metabolic and hemodynamic traits even after accounting for cumulative levels of these traits. The associations appear to vary by race and by child versus adult life stage. Future work may examine the mechanisms of these race-specific differences and implications for CVD event risk.