Cardiovascular Risk Factors in Childhood and Left Ventricular Diastolic Function in Adulthood

Author:

Heiskanen Jarkko S.12,Ruohonen Saku123,Rovio Suvi P.12,Pahkala Katja12,Kytö Ville124,Kähönen Mika5,Lehtimäki Terho6,Viikari Jorma S.A.7,Juonala Markus7,Laitinen Tomi8,Tossavainen Päivi9,Jokinen Eero10,Hutri-Kähönen Nina11,Raitakari Olli T.1212

Affiliation:

1. Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland;

2. Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland;

3. Orion Pharma, Turku, Finland;

4. Heart Center, Turku University Hospital, Turku, Finland;

5. Department of Clinical Physiology, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland;

6. Department of Clinical Chemistry, Fimlab Laboratories, and Finnish Cardiovascular Research Center - Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland;

7. Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland;

8. Department of Clinical Physiology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland;

9. Department of Pediatrics, PEDEGO Research Unit and Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland;

10. Department of Paediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland;

11. Department of Paediatrics, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; and

12. Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland

Abstract

BACKGROUND AND OBJECTIVES: Cardiovascular risk factors, such as obesity, blood pressure, and physical inactivity, have been identified as modifiable determinants of left ventricular (LV) diastolic function in adulthood. However, the links between childhood cardiovascular risk factor burden and adulthood LV diastolic function are unknown. To address this lack of knowledge, we aimed to identify childhood risk factors associated with LV diastolic function in the participants of the Cardiovascular Risk in Young Finns Study. METHODS: Study participants (N = 1871; 45.9% men; aged 34–49 years) were examined repeatedly between the years 1980 and 2011. We determined the cumulative risk exposure in childhood (age 6–18 years) as the area under the curve for systolic blood pressure, adiposity (defined by using skinfold and waist circumference measurements), physical activity, serum insulin, triglycerides, total cholesterol, and high- and low-density lipoprotein cholesterols. Adulthood LV diastolic function was defined by using E/é ratio. RESULTS: Elevated systolic blood pressure and increased adiposity in childhood were associated with worse adulthood LV diastolic function, whereas higher physical activity level in childhood was associated with better adulthood LV diastolic function (P < .001 for all). The associations of childhood adiposity and physical activity with adulthood LV diastolic function remained significant (both P < .05) but were diluted when the analyses were adjusted for adulthood systolic blood pressure, adiposity, and physical activity. The association between childhood systolic blood pressure and adult LV diastolic function was diluted to nonsignificant (P = .56). CONCLUSIONS: Adiposity status and the level of physical activity in childhood are independently associated with LV diastolic function in adulthood.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology, and Child Health

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