Muchira James M, Gona Philimon N, Mogos Mulubrhan F, Stuart-Shor Eileen M, Leveille Suzanne G, Piano Mariann R, Hayman Laura L
Center for Research Development and Scholarship, Vanderbilt University School of Nursing, Nashville, TN (J.M.M., M.F.M., M.R.P.).
Robert and Donna Manning College of Nursing and Health Sciences, University of Massachusetts Boston (P.N.G., E.S.-S., S.G.L., L.L.H.).
Circ Cardiovasc Qual Outcomes. 2023 Jan;16(1):e008809. doi: 10.1161/CIRCOUTCOMES.121.008809. Epub 2022 Dec 9.
Disability-adjusted life years (DALYs) are used to evaluate the relative burden of diseases in populations to help set prevention or treatment priorities. The impact of parental cardiovascular health (CVH) on healthy life years lost from cardiovascular disease (CVD) in adult offspring is unknown. We compared parent-offspring CVD DALYs trends over the life course and examined the association of parental CVH with offspring CVD DALYs.
Using data from the Framingham Heart Study, 4814 offspring-mother-father trios were matched for age at selected baseline exams. CVH score was computed from the number of CVH metrics attained at recommended levels: poor (0-2), intermediate (3-4), and ideal (5-7). CVD DALYs were defined as the sum of years of life lost and years lived with CVD. Age-sex-standardized life expectancy and disability weights were derived from the actuarial life tables and Global Burden of Disease study, respectively. Multivariable-adjusted linear regression was used to investigate the association of parental CVH with offspring CVD DALYs.
Over an equal 47-year follow-up, parents lost nearly twice the number of CVD DALYs compared to their offspring (23 234 versus 12 217). However, age-adjusted CVD DALYs were higher at younger ages and similar along the life course for parents and offspring. One-unit increase in parental CVH was associated with 5 healthy life months saved in offspring. Offspring of mothers with ideal versus poor CVH had 3 healthy life years saved (β=-3.0 DALYs [95% CI, -5.6 to -0.3]). No statistically significant association was found between paternal CVH categories and offspring CVD DALYs.
Higher maternal and paternal CVH were associated with increased healthy life years in offspring; however, the association was strongest between mothers and offspring. Investment in CVH promotion along the life course has the potential to reduce the burden of CVD in the current and future generation of adults.
伤残调整生命年（DALYs）用于评估人群中疾病的相对负担，以帮助确定预防或治疗的优先事项。父母心血管健康（CVH）对成年子女因心血管疾病（CVD）而损失的健康生命年的影响尚不清楚。我们比较了父母与子女在生命历程中CVD伤残调整生命年的趋势，并研究了父母CVH与子女CVD伤残调整生命年之间的关联。
利用弗雷明汉心脏研究的数据，在选定的基线检查中，对4814对子女-母亲-父亲三人组合进行年龄匹配。CVH评分根据达到推荐水平的CVH指标数量计算：差（0 - 2）、中等（3 - 4）和理想（5 - 7）。CVD伤残调整生命年定义为因CVD而损失的生命年数与患有CVD生存的年数之和。年龄-性别标准化预期寿命和残疾权重分别来自精算生命表和全球疾病负担研究。采用多变量调整线性回归来研究父母CVH与子女CVD伤残调整生命年之间的关联。
在相同的47年随访期内，父母损失的CVD伤残调整生命年数几乎是其子女的两倍（23234对12217）。然而，年龄调整后的CVD伤残调整生命年在年轻时较高，在父母和子女的生命历程中相似。父母CVH每增加一个单位，子女可节省5个健康生命月。母亲CVH理想与差的子女相比，可节省3个健康生命年（β = -3.0伤残调整生命年[95%置信区间，-5.6至-0.3]）。未发现父亲CVH类别与子女CVD伤残调整生命年之间存在统计学上的显著关联。
较高的母亲和父亲CVH与子女健康生命年的增加有关；然而，母亲与子女之间的关联最强。在生命历程中推广CVH的投入有可能减轻当代和后代成年人的CVD负担。
