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Canadian Journal of Cardiology
Systematic Review/Meta-analysis| Volume 33, ISSUE 2, P232-242, February 2017

Associations Between Childhood Cognition and Cardiovascular Events in Adulthood: A Systematic Review and Meta-analysis

Published:August 29, 2016DOI:https://doi.org/10.1016/j.cjca.2016.08.014

      Abstract

      Background

      The success of behavioural interventions to optimize cardiovascular health is dependent on adequate cognitive functioning beginning in early life. In this study we aimed to systematically review studies that examined associations between childhood cognition and cardiovascular disease (CVD) events in adulthood.

      Methods

      This study followed the Meta-analysis Of Observational Studies in Epidemiology guidelines to systematically examine associations between childhood cognition and adult CVD, coronary heart disease, and stroke hospitalization or mortality events. Literature was retrieved from EMBASE, MEDLINE, PsycInfo, and CINAHL.

      Results

      Five longitudinal studies that examined links between childhood cognition and CVD in adulthood were included. Pooled estimates of unadjusted CVD events indicated a relative risk of 1.23 (95% confidence interval, 1.12-1.34) per standard deviation decrease in childhood IQ, whereas the pooled estimate adjusted for biopsychosocial confounding factors indicated an overall relative risk of 1.16 (95% confidence interval, 1.07-1.26).

      Conclusions

      Lower childhood IQ is associated with an increased risk of cardiovascular events in adulthood, even after adjustment for confounding variables. Future research should examine the behavioural mechanisms by which these risks are mediated to optimize cardiovascular health.

      Résumé

      Introduction

      Le succès des interventions comportementales sur l’optimisation de la santé cardiovasculaire dépend d’un fonctionnement cognitif adéquat dès les premières années de la vie. Dans la présente étude, nous avions pour objectif de réaliser une revue systématique des études qui ont examiné les associations entre la cognition infantile et les événements liés à la maladie cardiovasculaire (MCV) à l’âge adulte.

      Méthodes

      Cette étude a suivi les lignes directrices de la MOOSE (Meta-analysis Of Observational Studies in Epidemiology, soit la méta-analyse d’études par observation en épidémiologie) pour examiner systématiquement les associations entre la cognition infantile et la MCV chez l’adulte, la coronaropathie, et l’hospitalisation à la suite d’un accident vasculaire cérébrale ou la mortalité. La littérature a été extraite d’EMBASE, de MEDLINE, de PsycINFO et de CINAHL.

      Résultats

      Cinq études longitudinales qui ont examiné les liens entre la cognition infantile et la maladie cardiovasculaire chez les adultes ont été incluses. Les estimations pondérées des événements non ajustés liés à la MCV ont indiqué un risque relatif de 1,23 (intervalle de confiance à 95 %, 1,12-1,34) par diminution de l’ÉT du QI durant l’enfance, tandis que l’estimation pondérée ajustée aux facteurs confusionnels biopsychosociaux a indiqué un risque relatif global de 1,16 (intervalle de confiance à 95 %, 1,07-1,26).

      Conclusions

      Un QI plus faible durant l’enfance est associé à une augmentation du risque d’événements cardiovasculaires à l’âge adulte, même après l’ajustement des variables confusionnelles. Les recherches futures devraient examiner les mécanismes comportementaux par lesquels ces risques sont influencés pour optimiser la santé cardiovasculaire.
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