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Canadian Journal of Cardiology

Differential Roles of Life-Course Cumulative Burden of Cardiovascular Risk Factors in Arterial Stiffness and Thickness

  • Bingbing Fan
    Affiliations
    Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China

    National Institute of Health Data Science, Shandong University, Jinan, Shandong, China
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  • Tao Zhang
    Correspondence
    Corresponding author: Dr Tao Zhang, Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, PO Box 100, 44 Wenhuaxi Road, Jinan 250012, China. Tel.: (+86) 531-88380280; fax: (+86) 531-88380280.
    Affiliations
    Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China

    National Institute of Health Data Science, Shandong University, Jinan, Shandong, China
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  • Shengxu Li
    Affiliations
    Children’s Minnesota Research Institute, Children’s Minnesota, Minneapolis, Minnesota, USA
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  • Yinkun Yan
    Affiliations
    Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA

    Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
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  • Lijun Fan
    Affiliations
    Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA

    Institute for Iodine Deficiency Disorders Prevention and Control, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
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  • Lydia Bazzano
    Affiliations
    Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
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  • Jiang He
    Affiliations
    Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
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  • Wei Chen
    Affiliations
    Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
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Published:March 18, 2022DOI:https://doi.org/10.1016/j.cjca.2022.03.009

      Abstract

      Background

      Data are limited regarding differential and common effects of cardiovascular risk factors on subclinical changes in vascular structure and function. We aimed to examine the relationships of life-course cumulative burdens of cardiovascular risk factors with adult arterial pulse wave velocity (PWV) and carotid intima-media thickness (CIMT) in a longitudinal cohort of the Bogalusa Heart Study.

      Methods

      The cohort consisted of 900 subjects who had aortic-femoral PWV and CIMT measurements. These participants were examined 5-16 times for body mass index (BMI), blood pressure, atherogenic index of plasma (AIP), and low-density lipoprotein cholesterol (LDLC) from childhood to adulthood. The area under the curve (AUC) was calculated as a measure of long-term burden of the risk factors.

      Results

      Adjusting for covariates, adult PWV was associated with AUCs of BMI, systolic blood pressure (SBP) and AIP (standardized regression coefficient [β] = 0.191, 0.321, 0.153, respectively; P < 0.001 for all). Adult CIMT was associated with AUCs of BMI, SBP, AIP and LDLC (β = 0.115, 0.202, 0.141, 0.152, respectively; P < 0.001 for all). Moreover, childhood BMI was associated with adult PWV and CIMT (β = 0.088 and 0.075, respectively; false discovery rate q values < 0.05 for both), and childhood LDLC with adult CIMT (β = 0.079; false discovery rate q value < 0.05). These associations did not differ significantly among race and sex groups.

      Conclusions

      The life-course cumulative burden of BMI, SBP, and AIP has common effects on arterial wall stiffening and thickening, whereas LDLC is specifically associated with arterial wall thickness, and this effect starts in early life.

      Résumé

      Contexte

      On dispose de peu de données au sujet des effets différentiels et communs des facteurs de risque cardiovasculaire sur les modifications infracliniques de la structure et de la fonction vasculaires. Nous avons cherché à examiner les liens entre le fardeau cumulatif des facteurs de risque cardiovasculaire au cours de la vie, la vitesse de l’onde de pouls (VOP) et l’épaisseur intima-média carotidienne (EIMC) chez l’adulte au sein d’une cohorte longitudinale de la Bogalusa Heart Study.

      Méthodologie

      La cohorte était composée de 900 sujets chez qui la VOP carotidofémorale (VOP aortique) et l’EIMC avaient été mesurées. Ces sujets avaient subi de 5 à 16 examens au cours desquels l’indice de masse corporelle (IMC), la pression artérielle, l’indice d’athérogénicité plasmatique (IAP) et le taux de cholestérol à lipoprotéines de faible densité (cLDL) avaient été mesurés, de l’enfance à l’âge adulte. L’aire sous la courbe (ASC) a été calculée en tant que mesure du fardeau à long terme des facteurs de risque.

      Résultats

      Après correction en fonction des covariables, la VOP chez l’adulte a été associée à l’ASC de l’IMC, de la pression artérielle systolique (PAS) et de l’IAP (coefficient de régression normalisé [β] = 0,191, 0,321 et 0,153, respectivement; P < 0,001 dans tous les cas). L’EIMC chez l’adulte a été associée à l’ASC de l’IMC, de la PAS, de l’IAP et du cLDL (β = 0,115, 0,202, 0,141 et 0,152, respectivement; P < 0,001 dans tous les cas). En outre, l’IMC chez l’enfant a été associé à la VOP et à l’EIMC chez l’adulte (β = 0,088 et 0,075, respectivement; taux de fausse découverte [valeur q] < 0,05 dans les deux cas), et le taux de cLDL chez l’enfant a été associé à l’EIMC chez l’adulte (β = 0,079; taux de fausse découverte [valeur q] < 0,05). Ces associations ne présentaient pas de différences interethniques ou intersexuelles significatives.

      Conclusions

      Le fardeau cumulatif de l’IMC, de la PAS et de l’IAP en cours de vie se traduit par des effets communs sur le durcissement et l’épaississement de la paroi artérielle, tandis que le taux de cLDL est spécifiquement associé à l’épaisseur de la paroi artérielle, et cet effet débute tôt dans la vie.
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      Linked Article

      • Measuring Cardiovascular Risk Across the Lifespan: When Should We Start Checking and What Should We Do About It?
        Canadian Journal of CardiologyVol. 38Issue 8
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          Studies evaluating the impact of cardiovascular risk factors (CVRFs) in children have been limited by a relative difficulty to demonstrate causative links with manifest atherosclerotic cardiovascular disease (CVD). With the exception of children with genetic disorders resulting in marked CVRF abnormalities (for example, homozygous familial hypercholesterolemia), atherosclerotic burden is typically early and clinically silent in children, adolescents, and young adults. Thus, cross-sectional evaluations of CVRFs in youth are often dependent on surrogate measures of atherosclerosis and vascular disease, including the use of carotid intima media thickness (cIMT) for atherosclerotic burden and pulse-wave velocity (PWV) for an assessment of vascular stiffness.
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