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    Childhood Risk Factors for Adult Cardiovascular Events

    iStock-1317036260An analysis of data collected from the International Childhood Cardiovascular Cohorts (i3C) Consortium was recently published in the New England Journal of Medicine, detailing the results of a remarkable study spanning a mean 35 years of follow-up for nearly 40,000 participants. The i3C includes seven cohorts from the US, Finland, and Australia, comprised of children (initially) between the ages of 3-19 (a mean of age 11.8), and this study provides a longitudinal prospective view of cardiovascular disease development.

    During this study period, 319 fatal cardiovascular events (CVE) occurred at a mean age of 47 +/- 8 years. Five traditional risk factors were examined during childhood, each of which was found to be associated with an increase in risk for adult CVE, including BMI, systolic blood pressure, total cholesterol level, triglyceride level, and youth smoking. For individual risk factors, this ranged from a hazard ratio for a fatal CVE of 1.3 for total cholesterol levels to a high of 1.61 for youth smoking, though when all 5 risk factors were combined the hazard ratio was 2.71.

    This study is important for a number of reasons; it provides additional strong evidence that cardiovascular disease is likely a lifelong process which begins during childhood, even though CVE are quite rare during childhood. The presence of these risk factors during adulthood (and the associated CV risk) to some degree reflects their presence during childhood, but this study also suggests that the change in risk from childhood to adulthood was also important in predicting outcomes. This highlights the importance of identifying risk during childhood, as suggested by the authors, and providing interventions which reduce the likelihood of disease during adulthood.

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