Childhood Risk Factors and Adulthood Cardiovascular Disease: A Systematic Review

Objective To conduct a comprehensive review of the literature on childhood risk factors and their associations with adulthood subclinical and clinical cardiovascular disease (CVD). Study design A systematic search was performed using the MEDLINE, EMBASE, PsycINFO, CINAHL, and Web of Science databases to identify English-language articles published through June 2018. Articles were included if they were longitudinal studies in community-based populations, the primary exposure occurred during childhood, and the primary outcome was either a measure of subclinical CVD or a clinical CVD event occurring in adulthood. Two independent reviewers screened determined whether eligibility criteria were met. Results There were 210 articles that met the predefined criteria. The greatest number of publications examined associations of clinical risk factors, including childhood adiposity, blood pressure, and cholesterol, with the development of adult CVD. Few studies examined childhood lifestyle factors including diet quality, physical activity, and tobacco exposure. Domains of risk beyond traditional cardiovascular risk factors, such as childhood psychosocial adversity, seemed to have strong published associations with the development of CVD. Conclusions Although the evidence was fairly consistent in direction and magnitude for exposures such as childhood adiposity, hypertension, and hyperlipidemia, significant gaps remain in the understanding of how childhood health and behaviors translate to the risk of adulthood CVD, particularly in lesser studied exposures like glycemic indicators, physical activity, diet quality, very early life course exposure, and population subgroups.

Automated summary

The study found that most publications focused on clinical risk factors such as childhood adiposity, blood pressure, and cholesterol with their associations with the development of adult CVD. Fewer studies examined childhood lifestyle factors like diet quality, physical activity, and tobacco exposure. Beyond traditional cardiovascular risk factors, domains of risk like childhood psychosocial adversity seemed to have strong associations with the development of CVD.