Early life determinants of cardiovascular health in adulthood. The Australian Aboriginal Birth Cohort study

Abstract

BackgroundIn 2010, The American Heart Association (AHA) set seven impact goals for ideal cardiovascular health (CVH): ideal blood pressure (BP), glucose, cholesterol levels and body mass index (BMI), physical activity on recommended levels, non-smoking and a healthy diet. We explored the prevalence of ideal CVH and the relationship between early life determinants and later CVH in an Aboriginal Birth Cohort in Australia. MethodsThe sample comprised 686 Aboriginal babies born in Darwin between 1987 and 1990. At birth, birthweight was measured and data was gathered about the families. A follow-up was conducted in adulthood. Prevalences of CVH metrics were assessed and each participant received an AHA score between 0 and 7. The relationship between socioeconomic factors at birth and later CVH was analysed. ResultsIdeal CVH was rare. Females had higher levels of ideal blood pressure (OR 5.87, P < 0.0001) and lower levels of ideal physical activity (OR 0.19, P < 0.0001). Low areal disadvantage was inversely associated with ideal levels of physical activity (OR 0.13, P = 0.04) and ideal BP (OR 0.06, P = 0.04). Participants living in urban environments had lower levels of ideal BP (OR 0.11, P = 0.03). Living in large households was inversely associated with non-smoking (OR 0.22, P = 0.02). High maternal BMI was inversely associated with ideal cholesterol (OR 0.13, P = 0.004) and ideal BP (OR 0.20, P = 0.04). ConclusionsSeveral early life factors affect later CVH in this cohort. These factors could be of significance in reducing the gap in cardiovascular mortality and morbidity between the Aboriginal and the non-Aboriginal populations in Australia.