Risk of cardiovascular disease measured by carotid intima-media thickness at age 49-51: lifecourse study.
OBJECTIVE
To quantify the direct and indirect effects of fetal life, childhood, and adult life on risk of cardiovascular disease at age 49-51 years.


METHODS
Follow up study of the "Newcastle thousand families" birth cohort established in 1947.


METHODS
154 men and 193 women who completed a health and lifestyle questionnaire and attended for clinical examination between October 1996 and December 1998.


METHODS
Correlations between mean intima-media thickness of the carotid artery (carotid intima-media thickness) and family history, birth weight, and socioeconomic position around birth; socioeconomic position, growth, illness, and adverse life events in childhood; and adult socioeconomic position, lifestyle, and biological risk markers. Proportions of variance in carotid intima-media thickness that were accounted for by each stage of the lifecourse.


RESULTS
Socioeconomic position at birth and birth weight were negatively associated with carotid intima-media thickness, although only social class at birth in women was a statistically significant covariate independent of adult lifestyle. These early life variables accounted directly for 2.2% of total variance in men and 2.0% in women. More variation in carotid intima-media thickness was explained by adult socioeconomic position and lifestyle, which accounted directly and indirectly for 3.4% of variance in men (95% confidence interval 0.5% to 6.2%) and 7.6% in women (2.1% to 13.0%). Biological risk markers measured in adulthood independently accounted for a further 9.5% of variance in men (2.4% to 14.2%) and 4.9% in women (1.6% to 7.4%).


CONCLUSIONS
Adult lifestyle and biological risk markers were the most important determinants of the cardiovascular health of the study members of the Newcastle thousand families cohort at age 49-51 years. The limited overall effect of early life factors may reflect the postwar birth year of this cohort.
Lamont
D
D
Department of Child Health, University of Newcastle, Sir James Spence Institute of Child Health, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP.
Parker
L
L
White
M
M
Unwin
N
N
Bennett
S M
SM
Cohen
M
M
Richardson
D
D
Dickinson
H O
HO
Adamson
A
A
Alberti
K G
KG
Craft
A W
AW
D002318:Cardiovascular Diseases / Q000209:etiology* / Q000473:pathology; D002340:Carotid Artery Diseases / Q000473:pathology*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008016:Life Change Events; D008019:Life Style; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012923:Social Class; D017539:Tunica Intima / Q000473:pathology*