Future of Families: Cardiovascular Health Among Young Adults Cohort Study: Rationale, Key Questions, Study Design, and Participant Characteristics

J Am Heart Assoc. 2025 Sep 2;14(17):e042030. doi: 10.1161/JAHA.125.042030. Epub 2025 Aug 29.

Abstract

Background: Childhood social determinants of adult cardiovascular health and potential mechanisms that link them are poorly understood. The FF-CHAYA (Future of Families-Cardiovascular Health Among Young Adults) study is designed to address these knowledge gaps.

Methods: The FF-CHAYA sample is a subcohort of the Future of Families and Child Wellbeing Study, which enrolled 4897 mother-baby dyads at delivery beginning in 1998 to 2000 and collected extensive data on neighborhood, family, school, and behavioral exposures at birth and offspring ages 1, 3, 5, 9, 15, and 22 years. From 2021 to 2023, we performed an in-person examination on 1421 offspring, including obtaining questionnaire responses addressing health status and health behaviors, and performance of anthropometry, blood pressure measurement, phlebotomy, and carotid ultrasonography using standardized protocols. An additional 620 offspring answered questionnaires electronically. Cardiovascular health status was quantified using the Life's Essential 8 score (0-100; higher is better cardiovascular health). Measurement of carotid intima-media thickness, grayscale lucency, and carotid distensibility was performed.

Results: Among 1975 nonpregnant participants, mean age was 23.2±0.8 years, 55% identified as female, 19.5% White, 49.1% Black, 26.7% Hispanic, and 4.7% as Asian or multiple race/ethnicity. Mean body mass index was 29.0±8.2 kg/m2, and mean Life's Essential 8 score was 69.2±13.0 points, with significant variation by demographic groups. Carotid measures indicate accelerated early arterial injury.

Conclusions: This article describes the rationale, study design and methods, and characteristics of the FF-CHAYA cohort, a novel longitudinal study designed to examine associations of childhood social determinants with young adult cardiovascular health and early arterial injury, as well as potential epigenetic mechanisms that may mediate these associations.

Keywords: cardiovascular health; carotid ultrasound; epigenetics; social determinants.

MeSH terms

  • Adolescent
  • Adult
  • Cardiovascular Diseases* / diagnosis
  • Cardiovascular Diseases* / epidemiology
  • Carotid Intima-Media Thickness
  • Child
  • Child, Preschool
  • Female
  • Health Behavior
  • Health Status
  • Humans
  • Infant
  • Male
  • Research Design
  • Social Determinants of Health*
  • Surveys and Questionnaires
  • United States / epidemiology
  • Young Adult