YI 1.2 Ideal Cardiovascular Health Score Declines from Adolescence to Emerging Adulthood

Abstract

PurposeTo define and compare cardiovascular (CV) health scores (CHS) from adolescence (17 yrs) to emerging adulthood (24 yrs) using longitudinal data from a large British birth cohort.Methods3142 participants from the Avon Longitudinal Study of Parents and Children (ALSPAC) study attended clinical investigations at 17.8 ± 0.4 yrs and 24.0 ± 0.8 yrs (38% male). CV health was assessed using smoking status, body mass index (BMI), plasma glucose, cholesterol, sitting brachial blood pressure, left ventricle (LV) hypertrophy, arterial stiffness (carotid-to-femoral pulse wave velocity) and atherosclerosis (carotid intima-media thickness) metrics. Prevalence was stratified into poor (0_points), intermediate (1_point) and ideal (2_points) health categories and a composite, individual-level CHS for all 8 metrics was calculated (total range, 0–16 points). Prevalence of ideal health was assessed using ANOVA and linear mixed modelling assessed age##sex modifications.ResultsOverall CHS was high at 17 yrs but from 17–24 yrs the proportion of ideal scores decreased for all metrics, in both sexes (Table). The average overall CHS decreased from 14.97 ± 1.1 to 13.99 ± 1.4 in males (p < 0.0001) and 14.82 ± 1.2 to 14.28 ± 1.4 in females (p < 0.0001, age##sex p = 0.0001). Significant sex differences were observed in the proportion of individuals with ideal health at both ages, with males having a higher CHS than females at 17 yrs but a lower CHS at 24 yrs.ConclusionsDespite being relatively early in the life-course, CV health declines from 17 yrs to 24 yrs in both sexes, and more substantially in males. Emerging adulthood is a distinct period of lifestyle change and an important time to control CV risk factors to improve future CV health.TableMale01Age17 yrs24 yrsAge0Age1Age2Age3Age4Score012012p0Score0Score1Score2Score3Score4Smoking22.619.358.127.835.636.6<0.000127.8Smoking0Smoking1Smoking2Smoking3Smoking4BMI4.913.382.110.430.059.6<0.00016.7BMI0BMI1BMI2BMI3BMI4Glucose0.49.190.50.634.764.7<0.00010.3Glucose0Glucose1Glucose2Glucose3Glucose4Cholesterol0.01.598.52.111.786.2<0.00010.1Cholesterol0Cholesterol1Cholesterol2Cholesterol3Cholesterol4Blood pressure0.20.599.30.65.494.0<0.00020.3Blood pressure0Blood pressure1Blood pressure2Blood pressure3Blood pressure4LV hypertrophy0.60.698.91.43.794.8<0.00010.5LV hypertrophy0LV hypertrophy1LV hypertrophy2LV hypertrophy3LV hypertrophy4Arterial stiffness0.50.998.64.86.788.5<0.00010.0Arterial stiffness0Arterial stiffness1Arterial stiffness2Arterial stiffness3Arterial stiffness4Atherosclerosis0.00.999.10.01.298.80.00050.0Atherosclerosis0Atherosclerosis1Atherosclerosis2Atherosclerosis3Atherosclerosis4Average CHS14.97 ± 1.113.99 ± 1.4<0.000114.82 ± 1.2Average CHS0Average CHS1Average CHS2Average CHS3Average CHS4Data are % of participants in each category for each risk factor. 0 = poor, 1 = intermediate and 2 = ideal. Age##sex p value for modification.