Context Exposure to cardiovascular risk factors during childhood and adolescence
may be associated with the development of atherosclerosis later in life.
Objective To study the relationship between cardiovascular risk factors measured
in childhood and adolescence and common carotid artery intima-media thickness
(IMT), a marker of preclinical atherosclerosis, measured in adulthood.
Design, Setting, and Participants Population-based, prospective cohort study conducted at 5 centers in
Finland among 2229 white adults aged 24 to 39 years who were examined in childhood
and adolescence at ages 3 to 18 years in 1980 and reexamined 21 years later,
between September 2001 and January 2002.
Main Outcome Measures Association between cardiovascular risk variables (levels of low-density
lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C],
and triglycerides; LDL-C/HDL-C ratio; systolic and diastolic blood pressure;
body mass index; smoking) measured in childhood and adulthood and common carotid
artery IMT measured in adulthood.
Results In multivariable models adjusted for age and sex, IMT in adulthood was
significantly associated with childhood LDL-C levels (P = .001), systolic blood pressure (P<.001),
body mass index (P = .007), and smoking (P = .02), and with adult systolic blood pressure (P<.001), body mass index (P<.001), and
smoking (P = .004). The number of risk factors measured
in 12- to 18-year-old adolescents, including high levels (ie, extreme age-
and sex-specific 80th percentile) of LDL-C, systolic blood pressure, body
mass index, and cigarette smoking, were directly related to carotid IMT measured
in young adults at ages 33 through 39 years (P<.001
for both men and women), and remained significant after adjustment for contemporaneous
risk variables. The number of risk factors measured at ages 3 to 9 years demonstrated
a weak direct relationship with carotid IMT at ages 24 to 30 years in men
(P = .02) but not in women (P =
Conclusions Risk factor profile assessed in 12- to 18-year-old adolescents predicts
adult common carotid artery IMT independently of contemporaneous risk factors.
These findings suggest that exposure to cardiovascular risk factors early
in life may induce changes in arteries that contribute to the development