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

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/e 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.

Automated summary

The study found that elevated systolic blood pressure and increased adiposity in childhood were associated with worse adulthood left ventricular diastolic function, while higher physical activity level in childhood was associated with better adulthood left ventricular diastolic function. However, the associations of childhood adiposity and physical activity with adulthood left ventricular diastolic function were weakened when adjusting for adulthood systolic blood pressure, adiposity, and physical activity. The association between childhood systolic blood pressure and adult left ventricular diastolic function became nonsignificant when adjusting for other factors in adulthood.