Preventable Risk Factors In Childhood Linked To Adult Heart Disease

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Five childhood risk factors, individually or combined, have been identified as predictors of fatal and non-fatal cardiovascular events in adulthood.

Body mass index, systolic blood pressure, total cholesterol level, triglyceride level, and youth smoking.

These five risk factors in childhood can increase the risk of heart attack as an adult, according to a new prospective cohort study led by the International Childhood Cardiovascular Cohorts Consortium (i3C).

Involving 38,589 participants in the i3C from Australia, Finland and the US who were tracked from age 3–19 years for a period of 35–50 years, the research is the world’s largest international prospective cardiovascular disease study. 

The results showed that 60% of children with the five combined risks factors had a 2–9-fold risk for adult cardiovascular disease, translating to risk nine times as much as those with below average risk factors.

In the analysis of 319 fatal cardiovascular events that occurred among all participants, the hazard ratios for a fatal cardiovascular event in adulthood ranged from 1.30 per unit increase in the risk score for total cholesterol level, to 1.61 for youth smoking.

Cardiovascular morbidity and mortality were noted from as early as 40 years of age.

Study co-author Professor Terence Dwyer from the Murdoch Children’s Research Institute said the results help to place the importance of early prevention further into the spotlight.

‘Despite the effect medical and surgical care has had on treating heart disease, the major impact will depend on effective preventive strategies,’ he said.

‘This study confirms that prevention should begin in childhood.’

Professor Dwyer also said the findings are not surprising given it has ‘been known for some time’ that children as young as five already showed early signs of fatty deposits in arteries.

Previous MCRI research had already linked high body mass index in early childhood to heart health issues in later childhood and adulthood.

However, similar longitudinal studies have been challenged by ‘a lack of inclusion of comprehensive childhood data’ around body measurements, blood pressure, and blood lipids, as well as a failure to follow-up at ages when cardiovascular disease becomes common, according to Professor Dwyer.

‘Studying early life influences on disease has always been put in the “too-hard basket”,’ he said.

‘But researchers in i3C took up this challenge because we knew the potential benefits to human health at the end could be very substantial.’

The study authors are calling for greater investment in public health strategies to reduce childhood risk factors, with the results warranting better programs to prevent the development of the five risk factors in children.

‘Clinicians and public health professionals should now start to focus on how this might best be achieved,’ Professor Dwyer said.

‘While interventions in adulthood like improving diet, quitting smoking, being more active, and taking appropriate medications to reduce risk factors are helpful, it is likely that there is much more that can be done during childhood and adolescence to reduce lifetime risk of cardiovascular disease.’

Dr. Mark L. Meyer Dr. Meyer graduated from Haverford College with a Bachelor of Science, High Honors, in cellular and molecular biology, Phi Beta Kappa, Magna Cum Laude. He attended the Yale University School of Medicine, where he also completed a categorical residency in Internal Medicine, served for one year as an Emergency Department attending physician, and held the title of Clinical Instructor in the Department of Surgery. During this time, Dr. Meyer obtained a J.D. from the Yale Law School, concentrating on medical ethics, scientific research law, and FDA law. He then completed a fellowship in Cardiovascular Diseases at the Hospital of the University of Pennsylvania, where he obtained Level 3 Nuclear Cardiology training.

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