Geisel School of Medicine at Dartmouth, Department of Community and Family Medicine, Hanover, NH 03755, USA.
Circulation. 2013 Feb 26;127(8):905-12. doi: 10.1161/CIRCULATIONAHA.112.115782. Epub 2013 Jan 22.
The American Heart Association's national goals for cardiovascular health promotion emphasize that cardiovascular risk originates early in life, but little is known about childhood factors that may increase the likelihood of having a favorable cardiovascular risk (FCR) in adulthood. We examined the prospective association between positive childhood factors and the likelihood of midlife FCR. We also considered pathways through which childhood factors may influence FCR.
We studied 415 adults (mean age=42.2 years) of the Collaborative Perinatal Project, a national cohort initiated in 1959 to 1966. We examined 3 positive childhood factors assessed at age 7 years: attention regulation (ability to stay focused), cognitive ability, and positive home environment. Of these adults, 10.6% had FCR in midlife. Adjusting for demographics and childhood cardiovascular health, a 1-unit increase in childhood attention regulation, cognitive ability, and positive home environment was associated with 2.4 (95% confidence interval, 1.1-4.7), 1.8 (95% confidence interval, 1.1-2.9), and 1.3 (95% confidence interval, 1.1-1.6) higher respective odds of having midlife FCR. The association with childhood attention regulation was maintained when accounting for adulthood factors; education and diet in part explained the associations with childhood cognitive ability and home environment. The effect of each attribute was additive as those with high levels of each childhood factor had 4.3 higher odds (95% confidence interval, 1.01-18.2) of midlife FCR in comparison with those low in all factors.
Positive childhood psychosocial factors may promote healthy adult cardiovascular functioning. Primordial prevention efforts aimed at preventing the development of cardiovascular risk should consider building on childhood psychosocial resources.
美国心脏协会的心血管健康促进国家目标强调心血管风险起源于生命早期，但对于可能增加成年后具有良好心血管风险（FCR）可能性的儿童期因素知之甚少。我们研究了积极的儿童期因素与中年 FCR 可能性之间的前瞻性关联。我们还考虑了儿童期因素影响 FCR 的途径。
我们研究了 415 名成年人（平均年龄 42.2 岁），他们是 1959 年至 1966 年启动的全国队列协作围产期项目的一部分。我们在 7 岁时评估了 3 种积极的儿童期因素：注意力调节（保持专注的能力）、认知能力和积极的家庭环境。在这些成年人中，10.6%在中年时具有 FCR。在调整人口统计学和儿童心血管健康后，儿童期注意力调节、认知能力和积极家庭环境每增加 1 个单位，与中年时具有 FCR 的几率分别增加 2.4（95%置信区间，1.1-4.7）、1.8（95%置信区间，1.1-2.9）和 1.3（95%置信区间，1.1-1.6）。当考虑成年因素时，与儿童注意力调节的关联仍然存在；教育和饮食部分解释了与儿童认知能力和家庭环境的关联。每个属性的影响是累加的，因为与所有因素水平较低的人相比，具有高水平的每个儿童期因素的人具有 4.3 倍更高的中年 FCR 几率（95%置信区间，1.01-18.2）。
积极的儿童期心理社会因素可能促进成年人健康的心血管功能。旨在预防心血管风险发展的原始预防工作应考虑利用儿童期心理社会资源。
