Abstract P189: Cardiovascular Risk Factors in Adolescence and Young Adulthood Predict Carotid Intima-Media Thickness in Early and Middle Adult Life

Abstract

Introduction: Cardiovascular (CV) risk factors measured in childhood and adulthood are positively associated with increased carotid intima-media thickness (cIMT) later in life. In particular, body mass index (BMI), systolic blood pressure (SBP), and lipids are implicated. However, questions remain regarding prediction of cIMT from adolescent and young adult CV risk factors. Hypothesis: CV risk factors are positively associated with young adult and early middle age cIMT thickening, both cross-sectionally and longitudinally. Methods: CV risk factors (BMI, SBP, metabolic syndrome [MetS, mean of CV risk factor z-scores]) were measured in two pediatric cohort studies. The Insulin Study measured CV risk factors in 305 adolescents at mean ages 15 and 22 years, with cIMT measured at mean age 22 years. The Prevention of High Blood Pressure in Children Study measured CV risk factors in 444 individuals at mean ages 24 and 38 years, with cIMT measured at mean age 38 years. Predictors were categorized into quartiles; cIMT was measured by ultrasonography. Linear regression models were used to predict cIMT and adjust for potential confounding variables. Differences between risk factor quartile 4 and quartile 1 (Q4-Q1) were used in analyses, with a p -test for trend based on continuous predictors. Results: Positive cross sectional associations were found between CV risk factors at ages 24 and 38 and cIMT at 38 (Table). Positive longitudinal associations were found between BMI (Q4-Q1: 0.024 mm, p=0.0001) and MetS score (Q4-Q1: 0.019 mm, p=0.004) at age 15 and cIMT at age 22, and between BMI (Q4-Q1: 0.045 mm, p=0.01) and MetS score (Q4-Q1: 0.048 mm, p<0.0001) at age 24 and cIMT at age 38 (Table). SBP at ages 24 and 38 was predictive of cIMT at age 38. Conclusions: These findings suggest that CV risk factors beginning in adolescence predict cIMT thickening in young adulthood, and this predictive association continues into middle age. This supports early identification of CV risk, and initiation of preventive strategies to reduce early CV disease.