Division of Internal Medicine, Department of Medicine (H.P.), Northwestern University Feinberg School of Medicine.
Department of Preventive Medicine (R.Z., A.M.P., N.B.A.), Northwestern University Feinberg School of Medicine.
Circ Res. 2023 Jun 9;132(12):1570-1583. doi: 10.1161/CIRCRESAHA.123.321998. Epub 2023 Jun 8.
Since it was first defined by the American Heart Association in 2010, cardiovascular health (CVH) has been extensively studied across the life course. In this review, we present the current literature examining early life predictors of CVH, the later life outcomes of child CVH, and the relatively few interventions which have specifically addressed how to preserve and promote CVH across populations. We find that research on CVH has demonstrated that prenatal and childhood exposures are consistently associated with CVH trajectories from childhood through adulthood. CVH measured at any point in life is strongly predictive of future cardiovascular disease, dementia, cancer, and mortality as well as a variety of other health outcomes. This speaks to the importance of intervening early to prevent the loss of optimal CVH and the accumulation of cardiovascular risk. Interventions to improve CVH are not common but those that have been published most often address multiple modifiable risk factors among individuals within the community. Relatively few interventions have been focused on improving the construct of CVH in children. Future research is needed that will be both effective, scalable, and sustainable. Technology including digital platforms as well as implementation science will play key roles in achieving this vision. In addition, community engagement at all stages of this research is critical. Lastly, prevention strategies that are tailored to the individual and their context may help us achieve the promise of personalized prevention and help promote ideal CVH in childhood and across the life course.
自 2010 年被美国心脏协会首次定义以来，心血管健康（CVH）已在整个生命历程中得到广泛研究。在这篇综述中，我们介绍了目前研究早期生活预测因素对 CVH 的影响、儿童 CVH 对后期生活的影响，以及相对较少的干预措施，这些干预措施专门探讨了如何在不同人群中保持和促进 CVH。我们发现，CVH 的研究表明，产前和儿童时期的暴露与儿童期到成年期的 CVH 轨迹始终相关。一生中任何时候测量的 CVH 都强烈预测未来的心血管疾病、痴呆、癌症和死亡率，以及各种其他健康结果。这说明了早期干预以防止失去最佳 CVH 和积累心血管风险的重要性。改善 CVH 的干预措施并不常见，但已发表的大多数干预措施都针对社区内个体的多个可改变的风险因素。相对较少的干预措施专注于改善儿童的 CVH 结构。需要开展未来的研究，这些研究既有效、可扩展又可持续。技术，包括数字平台以及实施科学，将在实现这一愿景中发挥关键作用。此外，在研究的所有阶段都需要社区参与。最后，针对个人及其背景的预防策略可能有助于我们实现个性化预防的承诺，并有助于促进儿童时期和整个生命历程中的理想 CVH。
