A1 Refereed original research article in a scientific journal

Influential Periods in Longitudinal Clinical Cardiovascular Health Scores




AuthorsKrefman 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 year2021

JournalAmerican Journal of Epidemiology

Volume190

Issue11

First page 2384

Last page2394

DOIhttps://doi.org/10.1093/aje/kwab149

Self-archived copy’s web addresshttps://research.utu.fi/converis/portal/detail/Publication/68436535


Abstract

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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