Year: 2024
Type: article
Abstract: BACKGROUND AND OBJECTIVES: Childhood risk factors are associated with cardiovascular events in adulthood. We compared the utility of a risk model based solely on nonlaboratory risk factors in adolescence versus a model that additionally included lipids to predict cardiovascular events in adulthood. METHODS: The study comprised 11 550 participants from 7 longitudinal cohort studies in the United States, Australia, and Finland with risk factor measurements in adolescence and followed into adulthood. The adolescent risk factors were defined by using clinical standards including overweight or obesity, elevated blood pressure, smoking, and borderline high or high levels of total cholesterol and triglycerides. The main outcomes were medically adjudicated fatal or nonfatal cardiovascular disease events occurring after age 25. RESULTS: Of 11 550 participants (55.1% female, mean age 50.0 ± 7.7 years), 513 (4.4%) had confirmed cardiovascular events. In a multivariable model (hazard ratio [95% confidence interval]), elevated blood pressure (1.25 [1.03-1.52]), overweight (1.76 [1.42-2.18]), obesity (2.19 [1.62-2.98]), smoking (1.63 [1.37-1.95]), and high total cholesterol (1.79 [1.39-2.31]) were predictors of cardiovascular events (P < .05). The addition of lipids (total cholesterol and triglycerides) into the nonlaboratory model (age, sex, blood pressure, BMI, and smoking) did not improve discrimination in predicting cardiovascular events (C-statistics for the lipid model 0.75 [SD 0.07] and nonlaboratory model 0.75 [0.07], P = .82). CONCLUSIONS: Nonlaboratory-based risk factors and lipids measured in adolescence independently predicted adult cardiovascular events. The addition of lipid measurements to nonlaboratory risk factors did not improve the prediction of cardiovascular events.
Source: PEDIATRICS
Authors: Joel Nuotio, Tomi T. Laitinen, Costan G. Magnussen, Alan R. Sinaiko, Lydia A. Bazzano, Stephen R. Daniels, David R. Jacobs, Noora Kartiosuo, Juha Koskinen, David P. Burgner, Mika Kähönen, Olli T. Raitakari, Julia Steinberger, Elaine M. Urbina, Alison J. Venn, Jorma S. A. Viikari, Jessica G. Woo, Terence Dwyer, Markus Juonala
Institutions: University of Turku, Turku University Hospital, Murdoch Children's Research Institute, Baker Heart and Diabetes Institute, University of Minnesota, Tulane University, Children's Hospital Colorado, University of Colorado Anschutz, University of Colorado Denver, Kymenlaakson keskussairaala, The University of Melbourne, Tampere University, Tampere University Hospital, University of Cincinnati, University of Tasmania, Cincinnati Children's Hospital Medical Center, University of Oxford
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4403379230