Longitudinal assessment between lifestyle-related risk factors and a composite cardiovascular disease (CVD) risk index among adolescents in Malaysia

Nithiah Thangiah,Tin Tin Su,Mohd Nahar Azmi Mohamed,Karuthan Chinna,Muhammad Yazid Jalaludin,Hazreen Abdul Majid

doi:10.1038/s41598-021-98127-0

Abstract

The study aims to create a composite risk index of CVD among adolescents and examine the influence of demographic, socioeconomic and lifestyle-related risk factors on the composite risk index of biological CVD risk factors among adolescents in Malaysia. A Malaysian adolescent cohort of 1320 adolescents were assessed at 13, 15 and 17 years. Seven biological CVD risk factors with moderate correlation were identified, standardized and averaged to form a composite CVD risk index. Generalised estimating equation using longitudinal linear regression was used to examine the effects of changes in adolescent lifestyle-related risk factors on the composite CVD risk index over time. From the ages 13 to 17 years, physical fitness (β = − 0.001, 90% CI = − 0.003, 0.00002) and BMI (β = 0.051, 95% CI = 0.042, 0.060) were significant predictors of attaining high scores of CVD risk. Female (β = 0.118, 95% CI = 0.040, 0.197), Chinese (β = 0.122, 95% CI = 0.006, 0.239), Indians (β = − 0.114, 95% CI = − 0.216, − 0.012) and adolescents from rural schools (β = 0.066, 95% CI = − 0.005, 0.136) were also found to be considerably significant. A more robust and gender-specific intervention programme focusing on healthy lifestyle (including achieving ideal BMI and improving physical fitness) need to be implemented among school-going adolescents.

Highlights

In Malaysia, cardiovascular disease (CVD) is the number one killer and accounts for 21.65% and 23.79% of all ten principal causes of deaths occurred in government and private hospitals, respectively in 2 0181
The effects of unhealthy diet and physical inactivity may manifest in individuals in the form of raised blood pressure, raised blood glucose, raised blood lipids, overweight and obesity can be classified as biological CVD risk factors[11]
The current study analyses the longitudinal association between overall CVD risk score and lifestyle-related risk factors controlled for demographic, socioeconomic factors and dietary intake among adolescents

Summary

Introduction

In Malaysia, cardiovascular disease (CVD) is the number one killer and accounts for 21.65% and 23.79% of all ten principal causes of deaths occurred in government and private hospitals, respectively in 2 0181. The most prominent risk factors of CVD in Malaysia are hypertension, hypercholesterolemia and obesity that have been increasing in prevalence at 30.0%, 38.1% and 50.1% respectively in 2 0194. Modifiable risk factors have an indirect relationship with the increased prevalence and death from CVD. In 2012, physical inactivity and unhealthy diet were identified as major risk factors of C VD9. These lifestyle risk factors are responsible for about 80% of coronary heart disease and cerebrovascular disease. The effects of unhealthy diet and physical inactivity may manifest in individuals in the form of raised blood pressure, raised blood glucose, raised blood lipids, overweight and obesity can be classified as biological CVD risk factors[11]. The objective of the study was to create a composite risk index for CVD among adolescents by averaging the standardized biological CVD risk factors and to examine the longitudinal relationship between lifestyle-related risk factors and the composite risk index for CVD among adolescents in Malaysia from the age of 13 to 17 years old

Objectives

Results

Conclusion