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

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Abstract

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/m2.7 lower (P < .001 for both) than in participants with poor CVH.

Conclusion:

Greater levels of CVH in young adulthood are associated with lower LV mass and lower risk for diastolic dysfunction 25 years later.

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