title: Vagal Regulation of Cardiac Function in Early Childhood and Cardiovascular Risk in Adolescence.
abstract: OBJECTIVE
  Poor behavioral self-regulation in the first 2 decades of life has been identified as an important precursor of disease risk in adulthood. However, physiological regulation has not been well studied as a disease risk factor before adulthood. We tested whether physiological regulation at the age of 2 years, in the form of vagal regulation of cardiac function (indexed by respiratory sinus arrhythmia [RSA] change), would predict three indicators of cardiovascular risk at the age of 16 years (diastolic and systolic blood pressure and body mass index).
  
  
  METHODS
  Data came from 229 children who participated in a community-based longitudinal study. At the age of 2 years, children were assessed for RSA baseline and RSA change (ln(ms)) in response to a series of challenge tasks. These same children were assessed again at the age of 16 years for diastolic and systolic blood pressure (millimeters of mercury), height (meters), and weight (kilogram).
  
  
  RESULTS
  Regression analyses revealed that less RSA withdrawal at the age of 2 years predicted higher diastolic blood pressure at the age of 16 years, adjusting for demographic characteristics (B = -3.07, M [S E] = 1.12, p = .006). Follow-up analyses demonstrated that these predictions extended to clinically significant levels of diastolic prehypertension (odds ratio = 0.43, 95% confidence interval = 0.22-0.89). RSA withdrawal did not significantly predict adolescent body mass index or systolic blood pressure.
  
  
  CONCLUSIONS
  Vagal regulation of cardiac function in early childhood predicts select indicators of cardiovascular risk 14 years later. Early signs of attenuated vagal regulation could indicate an increased risk for elevated blood pressure before adulthood. Future research should test biological, behavioral, and psychological mechanisms underlying these long-term predictions.
authors.affiliation: From the Department of Psychology (Gangel, Brown, Keane), University of North Carolina at Greensboro, Greensboro, North Carolina; Department of Psychology and Jacobs Center for Productive Youth Development (Shanahan), University of Zurich, Zurich, Switzerland; Department of Psychology and Neuroscience (Kolacz), University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and Departments of Kinesiology (Janssen, Wideman) and Human Development and Family Studies (Calkins), University of North Carolina at Greensboro, Greensboro, North Carolina.
authors.forename: Meghan J
authors.initials: MJ
authors.lastname: Gangel
authors.forename: Lilly
authors.initials: L
authors.lastname: Shanahan
authors.forename: Jacek
authors.initials: J
authors.lastname: Kolacz
authors.forename: James A
authors.initials: JA
authors.lastname: Janssen
authors.forename: Ashley
authors.initials: A
authors.lastname: Brown
authors.forename: Susan D
authors.initials: SD
authors.lastname: Calkins
authors.forename: Susan P
authors.initials: SP
authors.lastname: Keane
authors.forename: Laurie
authors.initials: L
authors.lastname: Wideman
mesh_terms: D000293:Adolescent; D001794:Blood Pressure / Q000502:physiology*; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000503:physiopathology*; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D065809:Respiratory Sinus Arrhythmia / Q000502:physiology*; D012306:Risk; D014630:Vagus Nerve / Q000502:physiology*