Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
Int J Cardiol. 2013 Oct 30;169(2):126-32. doi: 10.1016/j.ijcard.2013.08.090. Epub 2013 Sep 8.
The American Heart Association recently defined ideal cardiovascular health by simultaneous presence of seven health behaviors and factors. The concept is associated with cardiovascular disease incidence, and cardiovascular disease and all-cause mortality. To effectively promote ideal cardiovascular health already early in life, childhood factors predicting future ideal cardiovascular health should be investigated. Our aim was thus to comprehensively explore childhood determinants of adult ideal cardiovascular health in population based cohorts from three continents.
The sample comprised a total of 4409 participants aged 3-19 years at baseline from the Cardiovascular Risk in Young Finns Study (YFS; N = 1883) from Finland, Childhood Determinants of Adult Health Study (CDAH; N = 1803) from Australia and Princeton Follow-up Study (PFS; N = 723) from the United States. Participants were re-examined 19-31 years later when aged 30-48 years.
In multivariable analyses, independent childhood predictors of adult ideal cardiovascular health were family socioeconomic status (P < 0.01; direct association) and BMI (P < 0.001; inverse association) in all cohorts. In addition, blood pressure (P = 0.007), LDL-cholesterol (P < 0.001) and parental smoking (P = 0.006) in the YFS, and own smoking (P = 0.001) in CDAH were inversely associated with future ideal cardiovascular health.
Among several lifestyle and clinical indicators studied, higher family socioeconomic status and non-smoking (parental/own) in childhood independently predict ideal cardiovascular health in adulthood. As atherosclerotic cardiovascular diseases are rooted in childhood, our findings suggest that special attention could be paid to children who are from low socioeconomic status families, and who smoke or whose parents smoke, to prevent cardiovascular disease morbidity and mortality.
美国心脏协会最近通过同时存在七种健康行为和因素来定义理想的心血管健康。该概念与心血管疾病发病率以及心血管疾病和全因死亡率相关。为了在生命早期有效地促进理想的心血管健康，应该研究预测未来理想心血管健康的儿童时期因素。因此，我们的目标是全面探索来自三大洲的人群基础队列中成年理想心血管健康的儿童期决定因素。
该样本共包括来自芬兰心血管风险的年轻芬兰人研究（YFS；N=1883）、澳大利亚儿童期决定成人健康研究（CDAH；N=1803）和美国普林斯顿随访研究（PFS；N=723）的 4409 名年龄在 3-19 岁的参与者。参与者在 19-31 年后重新检查，当时年龄在 30-48 岁。
在多变量分析中，所有队列中，成年理想心血管健康的独立儿童期预测因素是家庭社会经济地位（P<0.01；直接关联）和 BMI（P<0.001；反向关联）。此外，YFS 中的血压（P=0.007）、LDL-胆固醇（P<0.001）和父母吸烟（P=0.006）以及 CDAH 中的自身吸烟（P=0.001）与未来理想心血管健康呈负相关。
在研究的几种生活方式和临床指标中，较高的家庭社会经济地位和儿童期不吸烟（父母/自己）独立预测成年后的理想心血管健康。由于动脉粥样硬化性心血管疾病起源于儿童时期，我们的研究结果表明，应该特别关注来自社会经济地位较低家庭的儿童，以及吸烟或其父母吸烟的儿童，以预防心血管疾病发病率和死亡率。
