Abstract
Background: No study has explored the modification effect of ideal cardiovascular health metrics (ICVHMs) on the association between famine exposure and risk of cardiovascular disease (CVD) so far. We aim to examine the effect of ICVHMs on the association between exposure to famine early in life and the risk of CVD in adulthood.Methods: A total of 61,527 participants free of CVD were included in this study from the Kailuan Study. All participants were divided into three groups, included nonexposed, fetal-exposed, and childhood-exposed groups. Cox regression was used to estimate the effect of famine exposure and ICVHMs on CVD risk.Results: After a median of 13.0 (12.7–13.2) years follow-up, 4,814 incident CVD cases were identified. Compared with nonexposed participants, the CVD risk increased in participants with fetal famine exposure (hazard ratio [HR]: 1.21; 95% CI: 1.07–1.37), but not in childhood famine-exposed participants. After stratifying by the number of ICVHMs, the increased CVD risk associated with fetal famine exposure was only observed in participants with less ICVHMs ( ≤ 2) (HR: 1.30; 95% CI: 1.11–1.52, P for interaction=0.008), but disappeared in those with three or more ICVHMs. The modified effect of ICVHMs was sex specific (P for sex interaction = 0.031).Conclusions: Exposing to famine in the fetal period could increase the risk of CVD in late life; however, ICVHMs might modify the effect of famine exposure on CVD risk, especially in men.
Highlights
Cardiovascular disease (CVD), the most common noncommunicable disease and the leading cause of mortality globally, is an important contributor to the disease burden [1]
To explore the modifying effect of ideal cardiovascular health metrics (ICVHMs), we evaluated the association between famine exposure and CVD by strata of the individual ICVHMs items and the number of ICVHMs
There were 13.9% (n = 8,572), who were exposed to the Great Chinese Famine in the fetal stage
Summary
Cardiovascular disease (CVD), the most common noncommunicable disease and the leading cause of mortality globally, is an important contributor to the disease burden [1]. Reducing the incidence of CVD will be helpful in lowering the burden of this disease and promoting health. Individuals who were born around the period experienced various severity of famine in early life and were the high-risk populations of CVD. Modifying or reversing the effect of famine exposure on CVD risk might help to reduce the incidence of CVD in these high-risk populations. No study has explored the modification effect of ideal cardiovascular health metrics (ICVHMs) on the association between famine exposure and risk of cardiovascular disease (CVD) so far. We aim to examine the effect of ICVHMs on the association between exposure to famine early in life and the risk of CVD in adulthood
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