Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku and Turku University Hospital, Turku, Finland.
Circulation. 2013 May 28;127(21):2088-96. doi: 10.1161/CIRCULATIONAHA.112.000761. Epub 2013 Apr 23.
In the Special Turku Coronary Risk Factor Intervention Project for Children (STRIP) study, repeated dietary counseling introduced in infancy and maintained until 20 years of age has led to lower intakes of saturated fat and serum low-density lipoprotein cholesterol. In this study, we examined prospectively the intervention effects on the ideal cardiovascular health concept recently described by the American Heart Association. Additionally, we investigated the association between the concept and vascular intima-media thickness and elasticity in adolescence.
In adolescents participating in the longitudinal, randomized, atherosclerosis-prevention STRIP study, complete data on ideal cardiovascular health metrics were available at 15 (n=394), 17 (n=376), and 19 (n=298) years of age. Aortic intima-media thickness and elasticity were measured with ultrasonography at the same ages. None of the adolescents had all 7 ideal cardiovascular health metrics. At least 5 ideal metrics was found in 60.2%, 45.5%, and 34.2% of the adolescents at 15, 17, and 19 years of age, respectively. Adolescents in the control group had an increased risk of low ideal cardiovascular health (≤3 metrics) compared with the intervention adolescents (risk ratio=1.35; 95% confidence interval=1.04-1.77). The number of ideal cardiovascular health metrics was inversely associated with aortic intima-media thickness (P<0.0001) and directly associated with elasticity (P=0.045). The risk of having high intima-media thickness (>85th percentile) was nearly 2-fold in adolescents with a low number of metrics (≤3) compared with those with a higher score (risk ratio=1.78; 95% confidence interval=1.31-2.43).
Ideal cardiovascular health as determined by the AHA can be promoted in adolescents. The ideal cardiovascular health concept is beneficially associated with vascular health already in adolescence, supporting the relevance of targeting these metrics as part of primordial prevention.
URL: http://www.clinicaltrials.gov. Unique identifier: NCT00223600.
在特殊图尔库儿童冠心病风险因素干预研究（STRIP）中，在婴儿期开始并持续到 20 岁的重复饮食咨询，导致饱和脂肪和血清低密度脂蛋白胆固醇的摄入量降低。在这项研究中，我们前瞻性地研究了最近由美国心脏协会描述的理想心血管健康概念的干预效果。此外，我们还研究了该概念与青春期血管内膜中层厚度和弹性之间的关系。
在参与这项纵向、随机、动脉粥样硬化预防 STRIP 研究的青少年中，15 岁（n=394）、17 岁（n=376）和 19 岁（n=298）时，有完整的理想心血管健康指标数据。在相同的年龄，通过超声测量主动脉内膜中层厚度和弹性。没有一个青少年拥有 7 项理想心血管健康指标。15 岁、17 岁和 19 岁时，分别有 60.2%、45.5%和 34.2%的青少年至少有 5 项理想指标。与干预组青少年相比，对照组青少年发生低理想心血管健康（≤3 项）的风险增加（风险比=1.35；95%置信区间=1.04-1.77）。理想心血管健康指标的数量与主动脉内膜中层厚度呈负相关（P<0.0001），与弹性呈正相关（P=0.045）。与得分较高的青少年相比，指标数量低（≤3）的青少年发生内膜中层厚度较高（>85 百分位）的风险几乎增加了 2 倍（风险比=1.78；95%置信区间=1.31-2.43）。
由美国心脏协会确定的理想心血管健康可以在青少年中得到促进。理想心血管健康概念与青春期的血管健康有益相关，支持将这些指标作为原始预防的一部分作为目标的相关性。
