title: Lifetime measures of ideal cardiovascular health and their association with subclinical atherosclerosis: The Cardiovascular Risk in Young Finns Study.
abstract: BACKGROUND
  The American Heart Association recently defined 7 ideal health behaviors and factors that can be used to monitor ideal cardiovascular health (ICH) over time. These relate to smoking, physical activity, diet, body mass index (BMI), blood pressure, blood glucose and total cholesterol. Associations between repeated measures of ICH across the life-course with outcomes of subclinical atherosclerosis in adult life have not been reported.
  
  
  RESULTS
  The sample comprised 1465 children and young adults aged 12 to 24 years (mean age 17.5 years) from the Cardiovascular Risk in Young Finns Study cohort. Participants were followed-up for 21 years since baseline (1986) and had complete ICH data available at baseline and follow-up. Average lifetime ICH index was associated with reduced risk of coronary artery calcification (CAC) (P=0.0004), high-risk carotid intima-media thickness (IMT) (P=0.0005) and high-risk carotid distensibility (<0.0001) in middle age. Participants with persistently low ICH status (lower than the median), as compared with persons with persistently high ICH status (higher than the median), had an increased risk of CAC (P=0.02), high-risk IMT (P=0.02), and high-risk distensibility (P<0.0001). Participants who improved their ICH status from low to high did not have a different risk of CAC (P=0.90), high-risk IMT (P=0.25), or high-risk distensibility (P=0.80) than participants who always had high ICH status.
  
  
  CONCLUSIONS
  The results show that ICH can be lost and regained, and importantly that regaining of ICH has a beneficial effect on cardiometabolic health. Health care providers should work to improve health behaviors especially in those who have lost ICH.
authors: Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland. Electronic address: tomi.laitinen@utu.fi.
authors: Tomi T
authors: TT
authors: Laitinen
authors: Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Paavo Nurmi Centre, Sports & Exercise Medicine Unit, Department of Physical Activity and Health University of Turku, Turku, Finland.
authors: Katja
authors: K
authors: Pahkala
authors: Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia.
authors: Costan G
authors: CG
authors: Magnussen
authors: Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
authors: Mervi
authors: M
authors: Oikonen
authors: Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland.
authors: Jorma S A
authors: JS
authors: Viikari
authors: Murdoch Childrens Research Institute, Royal Children's Hospital and University of Melbourne, Parkville, Victoria, Australia.
authors: Matthew A
authors: MA
authors: Sabin
authors: Department of Pediatrics, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, CO, USA.
authors: Stephen R
authors: SR
authors: Daniels
authors: Paavo Nurmi Centre, Sports & Exercise Medicine Unit, Department of Physical activity and Health, University of Turku, Turku, Finlad.
authors: Olli J
authors: OJ
authors: Heinonen
authors: Department of Pediatrics, University of Oulu, Vaasa, Finland; Vaasa Central Hospital, Vaasa, Finland.
authors: Leena
authors: L
authors: Taittonen
authors: Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
authors: Olli
authors: O
authors: Hartiala
authors: Department of Food and Environmental Sciences, University of Helsinki, Finland.
authors: Vera
authors: V
authors: Mikkilä
authors: Department of Pediatrics, University of Tampere and Tampere University Hospital, Tampere, Finland.
authors: Nina
authors: N
authors: Hutri-Kähönen
authors: Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland.
authors: Tomi
authors: T
authors: Laitinen
authors: Department of Clinical Physiology, University of Tampere and Tampere University Hospital, Tampere, Finland.
authors: Mika
authors: M
authors: Kähönen
authors: Research Centre of Applied and Preventive Cardiovascular, University of Turku, Turku, Finland; Department of Clinical Physiology, Turku University Hospital, Turku, Finland.
authors: Olli T
authors: OT
authors: Raitakari
authors: Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland; Murdoch Childrens Research Institute, Parkville, Victoria, Australia.
authors: Markus
authors: M
authors: Juonala
mesh_terms: D000293:Adolescent; D000328:Adult; D050197:Atherosclerosis / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D059168:Carotid Intima-Media Thickness; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D018570:Risk Assessment; D055815:Young Adult
keywords: Cardiovascular diseases; Children; Epidemiology; Longitudinal; Risk factors