Cardiovascular Health in Young Adulthood and Association with Left Ventricular Structure and Function Later in Life: The Coronary Artery Risk Development in Young Adults Study.
BACKGROUND
The aim of this study was to determine the association between cardiovascular health (CVH) in young adulthood and left ventricular (LV) structure and function later in life.


METHODS
Participants from the Coronary Artery Risk Development in Young Adults study, which recruited black and white participants aged 18 to 30 years at baseline, were included; echocardiography was performed at year 25. CVH at year 0 was defined on the basis of blood pressure, total cholesterol, fasting glucose, body mass index, smoking status, diet, and physical activity. Two, 1, or 0 points were assigned to each component for ideal, intermediate, and poor levels of each component. Participants were stratified into CVH groups on the basis of point score: ≤ 8 (poor), 9 to 11 (intermediate), and 12 to 14 (ideal).


RESULTS
The distribution of CVH at year 0 was as follows: poor, n = 264 (9%); intermediate, n = 1,315 (47%); and ideal, n = 1,224 (44%). Individuals with ideal and intermediate CVH at year 0 had significantly lower LV end-diastolic volume and lower LV mass index at year 25. In participants with ideal and intermediate CVH, the multivariate-adjusted odds ratios for diastolic dysfunction at year 25 was 0.52 (95% CI, 0.37-0.73) and 0.63 (95% CI, 0.46-0.83), respectively, compared with participants with poor CVH. Participants with ideal and intermediate CVH had significantly lower odds for LV hypertrophy; the LV mass index was 5.3 to 8.7 g/m(2.7) lower (P < .001 for both) than in participants with poor CVH.


CONCLUSIONS
Greater levels of CVH in young adulthood are associated with lower LV mass and lower risk for diastolic dysfunction 25 years later.
Division of Cardiology, Johns Hopkins Hospital, Baltimore, Maryland.
Chintan S
CS
Desai
Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Hongyan
H
Ning
Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Kiang
K
Liu
National Heart, Lung, and Blood Institute, Bethesda, Maryland.
Jared P
JP
Reis
Thomas Jefferson Medical Center, Philadelphia, Pennsylvania.
Samuel S
SS
Gidding
Division of Cardiology, Johns Hopkins Hospital, Baltimore, Maryland.
Anderson
A
Armstrong
Division of Cardiology, Johns Hopkins Hospital, Baltimore, Maryland.
Joao A C
JA
Lima
Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois. Electronic address: dlj@northwestern.edu.
Donald M
DM
Lloyd-Jones
D000293:Adolescent; D000328:Adult; D001794:Blood Pressure; D015992:Body Mass Index; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology*; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D015994:Incidence; D008297:Male; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D014481:United States / Q000453:epidemiology; D055815:Young Adult
Cardiovascular health; Echocardiography; Left ventricular mass