Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center University of Colorado Anschutz Medical Campus Aurora CO.
Department of Epidemiology Colorado School of Public Health University of Colorado Anschutz Medical Campus Aurora CO.
J Am Heart Assoc. 2024 Aug 6;13(15):e036279. doi: 10.1161/JAHA.124.036279. Epub 2024 Jul 31.
This study seeks to characterize cardiovascular health (CVH) from early childhood to late adolescence and identify sociodemographic correlates of high CVH that serve as levers for optimizing CVH across early life.
Among 1530 youth aged 3 to 20 years from 2 cohorts in the ECHO (Environmental Influences on Child Health Outcomes) consortium, we first derived CVH scores on the basis of the Life's Essential 8 construct comprising 4 behavioral (nicotine use/exposure, physical activity, sleep, and diet) and 4 health factors (body mass index, blood pressure, non-high-density lipoprotein cholesterol, and fasting glucose) during early childhood (mean age, 3.5 years), middle childhood (8.0 years), early adolescence (13.3 years), and late adolescence (17.8 years). Next, we used generalized regression to estimate the probability of high (versus not high) CVH with respect to sociodemographic characteristics. Overall CVH score was stable across life stages: 81.2±7.6, 83.3±8.0, and 81.7±8.9 of 100 possible points in early childhood, middle childhood, and early adolescence, respectively. Accordingly, during these life stages, most children (63.3%-71.5%) had high CVH (80 to <100). However, CVH declined by late adolescence, with an average score of 75.5±10.2 and 39.4% high CVH. No children had optimal CVH (score=100) at any time. Correlates of high CVH include non-Hispanic White race and ethnicity, maternal college education, and annual household income >$70 000. These associations were driven by behavioral factors.
Although most youth maintained high CVH across childhood, the decline by late adolescence indicates that cardiovascular disease prevention should occur before the early teen years. Disparities in high CVH over time with respect to sociodemographic characteristics were explained by behavioral factors, pointing toward prevention targets.
本研究旨在描述从儿童早期到青少年晚期的心血管健康状况，并确定与心血管健康状况较高相关的社会人口学因素，这些因素可作为优化整个儿童早期心血管健康的杠杆。
在 ECHO（环境对儿童健康结果的影响）联盟的 2 个队列中，共有 1530 名 3 至 20 岁的青少年，我们首先根据 Life's essential 8 构建来计算心血管健康状况评分，该构建包括 4 种行为因素（尼古丁使用/暴露、身体活动、睡眠和饮食）和 4 种健康因素（体重指数、血压、非高密度脂蛋白胆固醇和空腹血糖），这些因素在儿童早期（平均年龄 3.5 岁）、儿童中期（8.0 岁）、青少年早期（13.3 岁）和青少年晚期（17.8 岁）期间进行测量。接下来，我们使用广义回归估计了社会人口学特征与高（而非低）心血管健康状况之间的概率。总体心血管健康评分在整个生命阶段都保持稳定：儿童早期、儿童中期和青少年早期的得分为 100 分中的 81.2±7.6、83.3±8.0 和 81.7±8.9。因此，在这些生命阶段，大多数儿童（63.3%-71.5%）具有高心血管健康状况（80 至<100 分）。然而，到青少年晚期，心血管健康状况下降，平均得分为 75.5±10.2，39.4%的人具有高心血管健康状况。任何时候都没有儿童具有最佳的心血管健康状况（得分为 100）。高心血管健康状况的相关因素包括非西班牙裔白人种族和民族、母亲的大学教育程度以及家庭年收入>70000 美元。这些关联是由行为因素驱动的。
尽管大多数儿童在整个儿童期都保持较高的心血管健康状况，但到青少年晚期的下降表明，心血管疾病预防应在青少年早期之前进行。随着时间的推移，社会人口学特征与高心血管健康状况之间的差异可以通过行为因素来解释，这为预防提供了目标。
