A1 Refereed original research article in a scientific journal
Influential Periods in Longitudinal Clinical Cardiovascular Health Scores
Authors: Krefman Amy E, Labarthe Darwin, Greenland Philip, Pool Lindsay, Aguayo Liliana, Juonala Markus, Kähönen Mika, Lehtimäki Terho, Day R Sue, Bazzano Lydia, Muggeo Vito M R, Van Horn Linda, Liu Lei, Webber Larry S, Pahkala Katja, Laitinen Tomi T, Raitakari Olli, Lloyd-Jones Donald M, Allen Norrina B
Publication year: 2021
Journal: American Journal of Epidemiology
Volume: 190
Issue: 11
First page : 2384
Last page: 2394
DOI: https://doi.org/10.1093/aje/kwab149
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/68436535
The prevalence of ideal cardiovascular health (CVH) among adults in the United States is low and decreases with age. Our objective was to identify specific age windows when the loss of CVH accelerates, to ascertain preventive opportunities for intervention. Data were pooled from 5 longitudinal cohorts (Project Heartbeat!, Cardiovascular Risk in Young Finns Study, The Bogalusa Heart Study, Coronary Artery Risk Development in Young Adults, Special Turku Coronary Risk Factor Intervention Project) from the United States and Finland from 1973 to 2012. Individuals with clinical CVH factors (i.e., body mass index, blood pressure, cholesterol, blood glucose) measured from ages 8 to 55 years were included. These factors were categorized and summed into a clinical CVH score ranging from 0 (worst) to 8 (best). Adjusted, segmented, linear mixed models were used to estimate the change in CVH over time. Among the 18,343 participants, 9,461 (52%) were female and 12,346 (67%) were White. The baseline mean (standard deviation) clinical CVH score was 6.9 (1.2) at an average age of 17.6 (8.1) years. Two inflection points were estimated: at 16.9 years (95% confidence interval: 16.4, 17.4) and at 37.2 years (95% confidence interval: 32.4, 41.9). Late adolescence and early middle age appear to be influential periods during which the loss of CVH accelerates.
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