Cardiovascular Risk Factors in Childhood and Carotid Artery Intima-Media Thickness in Adulthood: The Cardiovascular Risk in Young Finns Study
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CONTEXT: Exposure to cardiovascular risk factors during childhood and adolescence may be associated with the development of atherosclerosis later in life. OBJECTIVE: To study the relationship between cardiovascular risk factors measured in childhood and adolescence and common carotid artery intima-media thickness (IMT), a marker of preclinical atherosclerosis, measured in adulthood. DESIGN, SETTING, AND PARTICIPANTS: Population-based, prospective cohort study conducted at 5 centers in Finland among 2229 white adults aged 24 to 39 years who were examined in childhood and adolescence at ages 3 to 18 years in 1980 and reexamined 21 years later, between September 2001 and January 2002. MAIN OUTCOME MEASURES: Association between cardiovascular risk variables (levels of low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], and triglycerides; LDL-C/HDL-C ratio; systolic and diastolic blood pressure; body mass index; smoking) measured in childhood and adulthood and common carotid artery IMT measured in adulthood. RESULTS: In multivariable models adjusted for age and sex, IMT in adulthood was significantly associated with childhood LDL-C levels (P =.001), systolic blood pressure (P<.001), body mass index (P =.007), and smoking (P =.02), and with adult systolic blood pressure (P<.001), body mass index (P<.001), and smoking (P =.004). The number of risk factors measured in 12- to 18-year-old adolescents, including high levels (ie, extreme age- and sex-specific 80th percentile) of LDL-C, systolic blood pressure, body mass index, and cigarette smoking, were directly related to carotid IMT measured in young adults at ages 33 through 39 years (P<.001 for both men and women), and remained significant after adjustment for contemporaneous risk variables. The number of risk factors measured at ages 3 to 9 years demonstrated a weak direct relationship with carotid IMT at ages 24 to 30 years in men (P =.02) but not in women (P =.63). CONCLUSIONS: Risk factor profile assessed in 12- to 18-year-old adolescents predicts adult common carotid artery IMT independently of contemporaneous risk factors. These findings suggest that exposure to cardiovascular risk factors early in life may induce changes in arteries that contribute to the development of atherosclerosis.
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Hypertension and obesity in childhood result in poor cardiovascular outcomes with age.
“Many groups have established that hypertension and obesity in childhood result in poor cardiovascular outcomes with age [23,24,25,26,27].”
From Recent Experimental Studies of Maternal Obesity, Diabetes during Pregnancy and the Developmental Origins of Cardiovascular Disease (2022) · cites this paper as [26]
The Comment section (page not supplied) reports that childhood systolic blood pressure and BMI were associated with adult carotid intima-media thickness, a surrogate marker of cardiovascular health. It also explicitly says there were no direct data linking childhood risk factors to adult cardiovascular disease. The claim overstates an association with a surrogate marker as a causal finding about cardiovascular outcomes. (LLM, conf=0.90)
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- Authors
- Raitakari, O. T., Juonala, M., Kähönen, M., Taittonen, L., Laitinen, T., Mäki-Torkko, N., Järvisalo, M. J., Uhari, M., Jokinen, E., Rönnemaa, T., Åkerblom, H. K., & Viikari, J. S. A.
- Affiliations
- University of Turku (FI)
- University of Helsinki (FI)
- Corresponding author
- Raitakari, Olli T.
- ORCID
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2003-11-05
- Volume
- 290
- Issue
- 17
- Pages
- 2277
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W2133591735
- Cited by
- 1,732
- References
- 3
- Citations by year
- 2026: 33 · 2025: 24 · 2024: 45 · 2023: 54 · 2022: 49 · 2021: 61 · 2020: 77 · 2019: 72 · 2018: 80 · 2017: 58 · 2016: 73 · 2015: 99 · 2014: 90 · 2013: 97 · 2012: 103
- FWCI
- 38.35
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- cardiovascular risk factors, childhood, adolescence, carotid intima-media thickness, preclinical atherosclerosis, LDL cholesterol, systolic blood pressure, body mass index, smoking, HDL cholesterol, triglycerides, LDL/HDL ratio, young adults, sex differences, risk factor accumulation, cardiovascular disease prevention, birth cohort follow-up
- MeSH terms
- Adolescent, Adult, Arteriosclerosis, Blood Pressure, Cardiovascular Diseases, Carotid Arteries, Child, Child, Preschool, Female, Finland, Humans, Lipoproteins, Longitudinal Studies, Male, Risk Factors, Smoking, Ultrasonography, Tunica Intima
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