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Associations of Blood Pressure and Cholesterol Levels During Young Adulthood With Later Cardiovascular Events.

TitleAssociations of Blood Pressure and Cholesterol Levels During Young Adulthood With Later Cardiovascular Events.
Publication TypeJournal Article
Year of Publication2019
AuthorsZhang Y, Vittinghoff E, Pletcher MJ, Allen NB, Hazzouri AZeki Al, Yaffe K, Balte PP, Alonso A, Newman AB, Ives DG, Rana JS, Lloyd-Jones D, Vasan RS, Bibbins-Domingo K, Gooding HC, de Ferranti SD, Oelsner EC
Secondary AuthorsMoran AE
JournalJ Am Coll Cardiol
Volume74
Issue3
Pagination330-341
Date Published2019 07 23
ISSN1558-3597
KeywordsAdolescent, Adult, Age Factors, Aged, Aged, 80 and over, Blood Pressure, Cardiovascular Diseases, Child, Child, Preschool, Cholesterol, HDL, Cholesterol, LDL, Female, Humans, Male, Middle Aged, Prospective Studies, Risk Factors, Young Adult
Abstract

BACKGROUND: Blood pressure (BP) and cholesterol are major modifiable risk factors for cardiovascular disease (CVD), but effects of exposures during young adulthood on later life CVD risk have not been well quantified.

OBJECTIVE: The authors sought to evaluate the independent associations between young adult exposures to risk factors and later life CVD risk, accounting for later life exposures.

METHODS: The authors pooled data from 6 U.S. cohorts with observations spanning the life course from young adulthood to later life, and imputed risk factor trajectories for low-density lipoprotein (LDL) and high-density lipoprotein cholesterols, systolic and diastolic BP starting from age 18 years for every participant. Time-weighted average exposures to each risk factor during young (age 18 to 39 years) and later adulthood (age ≥40 years) were calculated and linked to subsequent risks of coronary heart disease (CHD), heart failure (HF), or stroke.

RESULTS: A total of 36,030 participants were included. During a median follow-up of 17 years, there were 4,570 CHD, 5,119 HF, and 2,862 stroke events. When young and later adult risk factors were considered jointly in the model, young adult LDL ≥100 mg/dl (compared with 

CONCLUSIONS: Cumulative young adult exposures to elevated systolic BP, diastolic BP and LDL were associated with increased CVD risks in later life, independent of later adult exposures.

DOI10.1016/j.jacc.2019.03.529
Alternate JournalJ Am Coll Cardiol
PubMed ID31319915
PubMed Central IDPMC6764095
Grant ListK23 HL130627 / HL / NHLBI NIH HHS / United States
R01 HL130500 / HL / NHLBI NIH HHS / United States
R01 HL080295 / HL / NHLBI NIH HHS / United States
U01 HL130114 / HL / NHLBI NIH HHS / United States
R01 AG023629 / AG / NIA NIH HHS / United States
R01 AG028050 / AG / NIA NIH HHS / United States
R01 NR012459 / NR / NINR NIH HHS / United States
UL1 TR000040 / TR / NCATS NIH HHS / United States
UL1 TR001079 / TR / NCATS NIH HHS / United States
UL1 TR001420 / TR / NCATS NIH HHS / United States
RF1 AG054443 / AG / NIA NIH HHS / United States