Life-time risk factors and progression of carotid atherosclerosis in young adults: the Cardiovascular Risk in Young Finns study.
OBJECTIVE
The aim of this study is to evaluate whether childhood risk factors are associated with a 6-year change in carotid intima-media thickness (IMT) in young adulthood independent of the current risk factors.


RESULTS
The Cardiovascular Risk in Young Finns cohort consisted of 1809 subjects who were followed-up for 27 years since baseline (1980, age 3-18 years) and having carotid IMT measured both in 2001 and 2007. Cardiovascular risk factors were assessed repeatedly since childhood. A genotype risk score was calculated using 17 newly identified genetic variants associating with cardiovascular morbidity. The number of childhood risk factors (high LDL-cholesterol, low HDL-cholesterol, high blood pressure, obesity, diabetes, smoking, low physical activity, infrequent fruit consumption) was associated with a 6-year change in adulthood IMT. In subjects with 0, 1, 2, and > or =3 childhood risk factors, IMT [mean (95% CI)) increased by 35 (28-42), 46 (40-52), 49 (41-57), and 61 (49-73) microm (P = 0.0001). This association remained significant when adjusted for adulthood risk score and genotype score (P = 0.007). Of the individual childhood variables, infrequent fruit consumption ((beta (95% CI) for 1-SD change -5(-9 to -1), P = 0.03) and low physical activity (-6(-10 to -2), P = 0.01) were associated with accelerated IMT progression after taking into account these variables assessed in adulthood.


CONCLUSIONS
These findings indicate that children with risk factors have increased atherosclerosis progression rate in adulthood, and support the idea that the prevention of atherosclerosis by means of life style could be effective when initiated in childhood.
Juonala
Markus
M
Department of Medicine, University of Turku and Turku University Central Hospital, PO Box 52, 20500 Turku, Finland. mataju@utu.fi
Viikari
Jorma S A
JS
Kähönen
Mika
M
Taittonen
Leena
L
Laitinen
Tomi
T
Hutri-Kähönen
Nina
N
Lehtimäki
Terho
T
Jula
Antti
A
Pietikäinen
Matti
M
Jokinen
Eero
E
Telama
Risto
R
Räsänen
Leena
L
Mikkilä
Vera
V
Helenius
Hans
H
Kivimäki
Mika
M
Raitakari
Olli T
OT
D000293:Adolescent; D015992:Body Mass Index; D002339:Carotid Arteries / Q000473:pathology; D002340:Carotid Artery Diseases / Q000453:epidemiology* / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D008076:Cholesterol, HDL / Q000097:blood; D004032:Diet; D018450:Disease Progression; D015444:Exercise / Q000502:physiology; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008297:Male; D012307:Risk Factors; D017539:Tunica Intima / Q000473:pathology; D017540:Tunica Media / Q000473:pathology; D055815:Young Adult
D008076:Cholesterol, HDL