Abstract
Background Increased left ventricular mass (LVM) predicts cardiovascular events and mortality. The objective of this study was to determine whether early-life exposures to body mass index (BMI) and systolic blood pressure (SPB) affects the left ventricular structure in adulthood. Methods We used longitudinal data from a 31-year follow-up to examine the associations between early-life (between ages 6–18) BMI and SPB on LVM in an adult population (N = 1864, aged 34–49). The burden of early-life BMI and SBP was defined as area under the curve. Results After accounting for contemporary adult determinants of LVM, early-life BMI burden associated significantly with LVM (3.61 g/SD increase in early-life BMI; [1.94 − 5.28], p < 0.001). Overweight in early-life (age- and sex-specific BMI values corresponding to adult BMI > 25 kg/m2) associated with 4.7% (2.5–6.9%, p < 0.0001) higher LVM regardless of BMI status in adulthood. Overweight in early-life combined with obesity in adulthood (BMI > 30kg/m2) resulted in a 21% (17.3–32.9%, p < 0.0001) increase in LVM. Higher early-life BMI was associated with a risk of developing eccentric hypertrophy. The burden of early-life SPB was not associated with adult LVM or left ventricular remodeling. Conclusions High BMI in early-life confers a sustained effect on LVM and the risk for eccentric hypertrophy independently of adulthood risk factors. KEY MESSAGES Excess in BMI in early-life has an independent effect on LVM and the risk of developing eccentric hypertrophy regardless of overweight status in adulthood. Systolic blood pressure levels in early-life did not have an independent effect on LVM or LV remodeling. The clinical implication of this study is that primary prevention of obesity in early-life may prevent the development of high LVM and eccentric hypertrophy.
Highlights
Obesity and hypertension are the major modifiable risk factors for increased left ventricular (LV) remodeling and LV mass (LVM) in adults [1]
We found that the long-term burden of increased body mass index (BMI) in early-life is associated with increased left ventricular mass (LVM) and the risk of developing eccentric type hypertrophy in adulthood regardless of adult BMI in the Young Finns Study cohort
A review article by Ghosh et al [21] showed results of early-life high BMI resulting in worse cardiac structure but concluded that there is a lack of studies investigating the cumulative effect of lifecourse exposure to risk factors for cardiac structure
Summary
Obesity and hypertension are the major modifiable risk factors for increased left ventricular (LV) remodeling and LV mass (LVM) in adults [1]. In a study by Lai et al, childhood body mass index (BMI) and systolic blood pressure (SBP) were associated with higher LVM and with the risk of eccentric and concentric hypertrophy in adulthood [13]. Other known risk factors, e.g. alcohol usage and physical activity, were not assessed It is unclear if increased BMI or elevated SBP in childhood and adolescence can have long-lasting effects on LVM or LV remodeling in a general Caucasian population independent of adulthood risk-factors. The objective of this study was to determine whether early-life exposures to body mass index (BMI) and systolic blood pressure (SPB) affects the left ventricular structure in adulthood. Conclusions: High BMI in early-life confers a sustained effect on LVM and the risk for eccentric hypertrophy independently of adulthood risk factors
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