Childhood Cardiovascular Risk Factors and Carotid Vascular Changes in Adulthood: The Bogalusa Heart Study

JAMA. 2003 Nov 5;290(17):2271-6. doi: 10.1001/jama.290.17.2271.

Abstract

Context: Carotid artery intima-media thickness (IMT) is associated with cardiovascular risk factors and is recognized as an important predictive measure of clinical coronary atherosclerosis events in middle-aged and elderly populations. However, information on the association of carotid IMT in young adults with different risk factors measured in childhood, adulthood, or as a cumulative burden of each of the risk factors measured serially from childhood to adulthood is limited.

Objective: To examine the association between carotid IMT in young adults and traditional cardiovascular risk factors measured since childhood.

Design, setting, and participants: A cohort study of 486 adults aged 25 to 37 years from a semirural black and white community in Bogalusa, La (71% white, 39% men), who had at least 3 measurements of traditional risk factors since childhood, conducted between September 1973 and December 1996.

Main outcome measure: Association of carotid IMT with risk factors, including systolic blood pressure, lipoprotein levels, and body mass index.

Results: Male vs female (0.757 mm vs 0.719 mm) and black vs white (0.760 mm vs 0.723 mm) participants had increased carotid IMT (P<.001 for both). In multivariable analyses, significant predictors for being in top vs lower 3 quartiles of carotid IMT in young adults were childhood measures of low-density lipoprotein cholesterol (LDL-C) level (odds ratio [OR], 1.42, corresponding to 1-SD change specific for age, race, and sex; 95% confidence interval [CI], 1.14-1.78) and body mass index (BMI; OR, 1.25; 95% CI, 1.01-1.54); adulthood measures of LDL-C level (OR, 1.46; 95% CI, 1.16-1.82), high-density lipoprotein cholesterol (HDL-C) level (OR, 0.67; 95% CI, 0.51-0.88), and systolic blood pressure (OR, 1.36; 95% CI, 1.08-1.72); and long-term cumulative burden of LDL-C (OR, 1.58; 95% CI, 1.24-2.01) and HDL-C (OR, 0.75; 95% CI, 0.58-0.97) levels measured serially from childhood to adulthood. An increasing trend in carotid IMT across quartiles of LDL-C level measured in childhood was observed, with a mean value of 0.761 mm (95% CI, 0.743-0.780 mm) for those at the top quartile vs 0.724 mm (95% CI, 0.715-0.734 mm) for those in the lower 3 quartiles (P<.001).

Conclusions: Childhood measures of LDL-C level and BMI predict carotid IMT in young adults. The prevention implications of these findings remains to be explored.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • African Continental Ancestry Group
  • Blood Pressure
  • Body Mass Index
  • Cardiovascular Diseases / epidemiology*
  • Carotid Arteries / diagnostic imaging
  • Carotid Arteries / pathology*
  • Child
  • Cholesterol, LDL / blood
  • Cohort Studies
  • European Continental Ancestry Group
  • Female
  • Humans
  • Lipoproteins / blood
  • Louisiana / epidemiology
  • Male
  • Risk Factors
  • Tunica Intima / pathology
  • Ultrasonography

Substances

  • Cholesterol, LDL
  • Lipoproteins