Abstract P243: Psychosocial Strengths in Childhood Reduce Cardiometabolic Risk in Midlife: Longitudinal Findings From the 1958 British Birth Cohort

Abstract

Introduction: Reaching middle age with even one cardiovascular risk factor increases risk for morbidity and mortality. Yet once cardiovascular risk factors are in place, repairing or improving them can be difficult. One alternative is to promote healthy cardiovascular functioning during childhood. Although evidence indicates that adversity and psychological distress in childhood increase cardiovascular risk in adulthood, less research has examined protective childhood factors that enhance cardiovascular functioning and reduce risk over time. This research investigated if psychosocial strengths in childhood - such as positive emotions, optimism, purpose, satisfaction, and social connections - were associated with midlife cardiometabolic risk. Hypothesis: We hypothesized children with more versus fewer psychosocial strengths would have lower cardiometabolic risk in middle age. Methods: Data came from individuals in the 1958 British Birth Cohort, who have been repeatedly assessed from birth through adulthood. A subset of 11 year olds wrote an essay imagining their lives at age 25. Two trained judges rated 5,463 essays for the extent to which 9 psychosocial strengths were present (1=not at all; 7=very). The average rating across judges was calculated for each strength. All strengths were then averaged together for an overall score (α=.82). A cardiometabolic risk score was derived at age 45 from clinically-assessed systolic and diastolic blood pressure, resting heart rate, high-density lipoprotein cholesterol (reversed), total cholesterol, triglycerides, glycosylated hemoglobin, fibrinogen, and C-reactive protein. Each biomarker was standardized and then summed (higher numbers indicated more cardiometabolic risk). Missing values were multiply imputed, then linear regression analyses determined associations between psychosocial strengths and cardiometabolic risk. Results: In unadjusted models, having more psychosocial strengths was significantly associated with lower cardiometabolic risk (b=-.42, se=.08, p<.0001). After adjusting for sex and financial hardship in childhood, the association was maintained (b=-.20, se=.08, p=.009). However, adding childhood cognitive ability and essay word count (b=-.09, se=.08, p=.24), as well as childhood health-related variables (heart complaints, height, weight) and adulthood cardiovascular medication use (b=-.10, se=.07, p=.18), attenuated the association. Conclusions: Children with more psychosocial strengths tended to have reduced cardiometabolic risk in midlife. These associations were accounted for by other child attributes that may cluster with psychosocial strengths. With a primordial prevention framework and innovative methods to assess childhood psychosocial strengths, this study contributes to growing evidence about factors in early life that may reduce cardiometabolic risk across the lifespan.