Risk Scores for Five Early Life Domains and Odds of Obesity and Hypertension Comorbidity

Abstract

Abstract Background For outcomes such as obesity and hypertension, determinants are likely to be complex and multidimensional. Therefore, to design realistic interventions, epidemiological research should incorporate information from multiple risk exposure domains to assess the effect on health. In this paper we explore risk scores for five early life domains and odds of obesity and hypertension comorbidity. Methods We used data from 17,196 participants in the 1970 British Cohort Study. The outcome was obesity (BMI of ≥ 30) and hypertension (blood pressure>140/90mm Hg or self-reported doctor’s diagnosis) comorbidity at age 46. Early life domains included: ‘prenatal, antenatal, neonatal and birth’, ‘developmental attributes and behaviour’, ‘child education and academic ability’, ‘socioeconomic factors’ and ‘parental and family environment’. Stepwise backward elimination selected variables for inclusion for each domain. Predicted risk scores of obesity and hypertension for each cohort member within each domain were calculated. Logistic regression investigated the association between domain-specific risk scores and odds of obesity-hypertension, controlling for demographic factors and other domains. Results In unadjusted models, higher domain-specific risk scores were associated with increased odds of obesity-hypertension comorbidity. In adjusted analyses, higher domain-specific risk scores remained associated with increased odds of obesity-hypertension comorbidity, with the strongest associations to the parental and family environment domain (OR1.11 95%CI 1.05-1.18) and the socioeconomic factors domain (OR1.11 95%CI 1.05-1.17). Conclusions Appropriate modelling choices of combined effects of early-life risk factors need to be explored and tested. Targeted prevention interventions aimed at population groups with shared early-life characteristics could have an impact on cardiovascular risk in adulthood. Key messages • Targeted prevention interventions aimed at population groups with shared early-life characteristics could have an impact on obesity-hypertension prevalence. • Appropriate modelling choices of combined effects of early-life risk factors need to be explored and tested.