Early-life cardiovascular risk factor trajectories and vascular aging in midlife: a 30-year prospective cohort study

Wang, Y. et al. (2023) Early-life cardiovascular risk factor trajectories and vascular aging in midlife: a 30-year prospective cohort study. Hypertension, 80(5), pp. 1057-1066. (doi: 10.1161/HYPERTENSIONAHA.122.20518) (PMID:36880389)

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Abstract

Background: Vascular aging, as assessed by structural and functional arterial properties, is an independent predictor of cardiovascular outcomes. We aimed to explore the associations of individual cardiovascular risk factors from childhood to midlife and their accumulation over a 30-year span with vascular aging in midlife. Methods: Using data from the ongoing cohort of Hanzhong Adolescent Hypertension study, 2180 participants aged 6 to 18 years at baseline were followed for over 30 years. Distinct trajectories of systolic blood pressure (SBP), body mass index (BMI), and heart rate from childhood to midlife were identified by group-based trajectory modeling. Vascular aging was assessed by carotid intima media thickness or brachial-ankle pulse wave velocity. Results: We identified 4 distinct SBP trajectories, 3 distinct BMI trajectories, and 2 distinct heart rate trajectories from childhood to midlife. Persistently increasing SBP, high-increasing BMI, and high-stable heart rate were all shown to have a positive association with brachial-ankle pulse wave velocity in midlife. For carotid intima–media thickness, similar associations were observed for persistently increasing SBP and high-increasing body mass index. After further adjustment for SBP, body mass index and heart rate at the time of vascular assessment in 2017, associations were also observed for cardiovascular risk factor trajectories accumulation with brachial-ankle pulse wave velocity (β, 0.656 [95% CI, 0.265–1.047]) and with carotid intima media thickness (β, 0.045 [95% CI, 0.011–0.079]) in adulthood. Conclusions: Longitudinal exposure to individual cardiovascular risk factors from childhood to midlife and cardiovascular risk factor accumulation were associated with an increased risk of vascular aging in midlife. Our study lends support for early targeting of risk factors in order to prevent cardiovascular disease later in life.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Delles, Professor Christian
Authors: Wang, Y., Wang, J., Zheng, X.-W., Du, M.-F., Zhang, X., Chu, C., Wang, D., Liao, Y.-Y., Ma, Q., Jia, H., Hu, G.-L., Yan, Y., Sun, Y., Chen, C., Zhang, X.-Y., Li, H., Zou, T., Niu, Z.-J., Man, Z.-Y., Wang, L., Luo, W.-J., Wu, G.-J., Kang, Y.-M., Chang, J., Delles, C., Lu, Y., and Mu, J.-J.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
Journal Name:Hypertension
Publisher:American Heart Association
ISSN:0194-911X
ISSN (Online):1524-4563
Published Online:07 March 2023
Copyright Holders:Copyright © 2023 American Heart Association, Inc.
First Published:First published in Hypertension 80(5): 1057-1066
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
303944BHF Centre of ExcellenceColin BerryBritish Heart Foundation (BHF)RE/18/6/34217CAMS - Cardiovascular Science