Abstract 17314: Trajectories in Cardiovascular Health From Childhood Through Middle Age

Introduction: Cross-sectional measures of cardiovascular health (CVH) metrics early in life have been associated with cardiovascular disease in older age. Little is known about long-term patterns in CVH starting in childhood. Methods: We pooled data from five prospective childhood/early adulthood cohorts (Bogalusa, Young Finns, HeartBeat!, CARDIA, STRIP), including participants aged 8 - 55y with 3+ exams. CVH metrics (BP, BMI, cholesterol, glucose) were categorized as poor, intermediate and ideal (scored 0, 1, 2 respectively) and summed as a clinical CVH score from 0 to 8 with a higher score indicating more favorable CVH. Group-based modeling techniques (PROC TRAJ) identified trajectories in this score, and trajectory groups were compared with respect to demographic, risk factors and lifestyle characteristics. Results: Among 9,585 participants we identified 5 distinct trajectory groups over ages 8- 55y (Figure): High-Stable had sustained ideal scores (16% of participants); High-Slow Decline, initially high and gradually declining scores (27%); High-Rapid Decline, initially high scores declining more rapidly (32%); Intermediate-Stable, sustained intermediate scores (15%); Intermediate-Rapid Decline, initially intermediate scores with rapid declines in early adulthood (10%). Groups with rapid declines had the highest proportions of males and African-Americans. The High-Stable group more often had ideal diet and physical activity scores at baseline (53% and 30%, respectively) than other groups (p Conclusion: In general, individuals’ cardiovascular health declines as they move from childhood into adulthood. Only 16% of participants maintained ideal CVH scores from childhood through middle age. Individuals with unhealthy lifestyle factors such as a poor diet and physical inactivity are more likely to experience rapid declines in CVH in adolescence and middle-age. Prevention efforts are needed early in life to prevent the loss of CVH.