title: Impact of long-term burden of excessive adiposity and elevated blood pressure from childhood on adulthood left ventricular remodeling patterns: the Bogalusa Heart Study.
abstract: BACKGROUND
  Cardiovascular risk factors are associated with left ventricular hypertrophy (LVH), but little is known regarding related impact of longitudinal measures of childhood adiposity and LV hemodynamic variables.
  
  
  OBJECTIVE
  The aim of this study was to examine the impact of cumulative long-term burden and trends of excessive adiposity and elevated blood pressure (BP) during childhood on adulthood LVH and LV geometric remodeling patterns.
  
  
  METHODS
  This longitudinal study consisted of 1,061 adults, age 24 to 46 years, who had been examined 4 or more times for body mass index (BMI) and BP starting in childhood, with a mean follow-up of 28.0 years. The area under the curve (AUC) was calculated as a measure of long-term burden (total AUC) and trends (incremental AUC) of BMI and BP from childhood to adulthood. Four LV geometric types were defined-normal, concentric remodeling (CR), eccentric hypertrophy (EH), and concentric hypertrophy (CH)-all on the basis of LV mass indexed for body height (m(2.7)) and relative wall thickness.
  
  
  RESULTS
  Higher values of BMI and systolic and diastolic BP in childhood and adulthood, as well as total AUC and incremental AUC, were all significantly associated with higher LV mass index and LVH, adjusted for race, sex, and age. In addition, higher values of BMI and BP in childhood and adulthood, total AUC, and incremental AUC were significantly associated with EH and CH but not with CR. Importantly, all of these measures of BMI had a consistently and significantly greater influence on EH than did measures of BP.
  
  
  CONCLUSIONS
  These findings indicate that the adverse influence of excessive adiposity and elevated BP levels on LVH begins in childhood.
authors.affiliation: Department of Epidemiology, Tulane University, New Orleans, Louisiana; Department of Cardiology, Peking Union Medical College Hospital, Beijing, China.
authors.forename: Chin-Chih
authors.initials: CC
authors.lastname: Lai
authors.affiliation: Department of Epidemiology, Tulane University, New Orleans, Louisiana; Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China.
authors.forename: Dianjianyi
authors.initials: D
authors.lastname: Sun
authors.affiliation: Department of Epidemiology, Tulane University, New Orleans, Louisiana.
authors.forename: Ruiqi
authors.initials: R
authors.lastname: Cen
authors.affiliation: The First Affiliated Hospital, Shanxi Medical University, Taiyuan, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Epidemiology, Tulane University, New Orleans, Louisiana.
authors.forename: Shengxu
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Epidemiology, Tulane University, New Orleans, Louisiana.
authors.forename: Camilo
authors.initials: C
authors.lastname: Fernandez-Alonso
authors.affiliation: Department of Epidemiology, Tulane University, New Orleans, Louisiana. Electronic address: wchen1@tulane.edu.
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.affiliation: Department of Epidemiology, Tulane University, New Orleans, Louisiana.
authors.forename: Sathanur R
authors.initials: SR
authors.lastname: Srinivasan
authors.affiliation: Department of Epidemiology, Tulane University, New Orleans, Louisiana.
authors.forename: Gerald S
authors.initials: GS
authors.lastname: Berenson
mesh_terms: D050154:Adiposity / Q000502:physiology*; D000293:Adolescent; D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D018450:Disease Progression; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling / Q000502:physiology*; D055815:Young Adult
keywords: adiposity; blood pressure; geometric remodeling; left ventricular hypertrophy; longitudinal analysis