title: Adolescence risk factors are predictive of coronary artery calcification at middle age: the cardiovascular risk in young Finns study.
abstract: OBJECTIVE
  The purpose of this study was to examine the roles of adolescence risk factors in predicting coronary artery calcium (CAC).
  
  
  BACKGROUND
  Elevated coronary heart disease risk factor levels in adolescence may predict subsequent CAC independently of change in risk factor levels from adolescence to adulthood.
  
  
  METHODS
  CAC was assessed in 589 subjects 40 to 46 years of age from the Cardiovascular Risk in Young Finns Study. Risk factor levels were measured in 1980 (12 to 18 years) and in 2007.
  
  
  RESULTS
  The prevalence of any CAC was 19.2% (27.9% in men and 12.2% in women). Age, levels of systolic blood pressure (BP), total cholesterol, and low-density lipoprotein cholesterol (LDL-C) in adolescence, as well as systolic BP, total cholesterol, diastolic BP, and pack-years of smoking in adulthood were higher among subjects with CAC than those without CAC. Adolescence LDL-C and systolic BP levels predicted CAC in adulthood independently of 27-year changes in these risk factors. The multivariable odds ratios were 1.34 (95% confidence interval: 1.05 to 1.70; p=0.02) and 1.38 (95% confidence interval: 1.08 to 1.77; p=0.01), for 1-SD increase in adolescence LDL-C and systolic BP, respectively. Exposure to both of these risk factors in adolescence (defined as values at or above the age- and sex-specific 75th percentile) substantially increased the risk of CAC (multivariable odds ratio: 3.5 [95% confidence interval: 1.7 to 7.2; p=0.007]) between groups with no versus both risk factors.
  
  
  CONCLUSIONS
  Elevated adolescence LDL-C and systolic BP levels are independent predictors of adulthood CAC, indicating that adolescence risk factor levels play an important role in the pathogenesis of coronary heart disease.
authors.affiliation: Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, and Turku PET Center, Turku University Hospital, Turku, Finland. olli.hartiala@utu.fi
authors.forename: Olli
authors.initials: O
authors.lastname: Hartiala
authors.forename: Costan G
authors.initials: CG
authors.lastname: Magnussen
authors.forename: Sami
authors.initials: S
authors.lastname: Kajander
authors.forename: Juhani
authors.initials: J
authors.lastname: Knuuti
authors.forename: Heikki
authors.initials: H
authors.lastname: Ukkonen
authors.forename: Antti
authors.initials: A
authors.lastname: Saraste
authors.forename: Irina
authors.initials: I
authors.lastname: Rinta-Kiikka
authors.forename: Sakari
authors.initials: S
authors.lastname: Kainulainen
authors.forename: Mika
authors.initials: M
authors.lastname: Kähönen
authors.forename: Nina
authors.initials: N
authors.lastname: Hutri-Kähönen
authors.forename: Tomi
authors.initials: T
authors.lastname: Laitinen
authors.forename: Terho
authors.initials: T
authors.lastname: Lehtimäki
authors.forename: Jorma S A
authors.initials: JS
authors.lastname: Viikari
authors.forename: Jaakko
authors.initials: J
authors.lastname: Hartiala
authors.forename: Markus
authors.initials: M
authors.lastname: Juonala
authors.forename: Olli T
authors.initials: OT
authors.lastname: Raitakari
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002114:Calcinosis / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003324:Coronary Artery Disease / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D003331:Coronary Vessels / Q000473:pathology*; D003430:Cross-Sectional Studies; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D013997:Time Factors; D055815:Young Adult