Adult socioeconomic position and lifestyle accounted for 3.4% of variance in carotid intima-media thickness in men and 7.6% in women, compared to 2.2% and 2.0% for early life variables.
Cohort (n=347)
What are the relative contributions of fetal, childhood, and adult life factors to the risk of cardiovascular disease measured by carotid intima-media thickness at age 49-51?
Adult lifestyle and biological risk markers are more important determinants of cardiovascular health (measured by carotid IMT) at age 49-51 than early life factors in this cohort.
OBJECTIVE: To quantify the direct and indirect effects of fetal life, childhood, and adult life on risk of cardiovascular disease at age 49-51 years. DESIGN: Follow up study of the "Newcastle thousand families" birth cohort established in 1947. PARTICIPANTS: 154 men and 193 women who completed a health and lifestyle questionnaire and attended for clinical examination between October 1996 and December 1998. MAIN OUTCOME MEASURES: Correlations between mean intima-media thickness of the carotid artery (carotid intima-media thickness) and family history, birth weight, and socioeconomic position around birth; socioeconomic position, growth, illness, and adverse life events in childhood; and adult socioeconomic position, lifestyle, and biological risk markers. Proportions of variance in carotid intima-media thickness that were accounted for by each stage of the lifecourse. RESULTS: Socioeconomic position at birth and birth weight were negatively associated with carotid intima-media thickness, although only social class at birth in women was a statistically significant covariate independent of adult lifestyle. These early life variables accounted directly for 2.2% of total variance in men and 2.0% in women. More variation in carotid intima-media thickness was explained by adult socioeconomic position and lifestyle, which accounted directly and indirectly for 3.4% of variance in men (95% confidence interval 0.5% to 6.2%) and 7.6% in women (2.1% to 13.0%). Biological risk markers measured in adulthood independently accounted for a further 9.5% of variance in men (2.4% to 14.2%) and 4.9% in women (1.6% to 7.4%). CONCLUSIONS: Adult lifestyle and biological risk markers were the most important determinants of the cardiovascular health of the study members of the Newcastle thousand families cohort at age 49-51 years. The limited overall effect of early life factors may reflect the postwar birth year of this cohort.
D. Lamont (Sat,) conducted a cohort in Cardiovascular disease risk (n=347). Lifecourse factors (fetal, childhood, and adult life) was evaluated on Proportions of variance in carotid intima-media thickness accounted for by each stage of the lifecourse. Adult socioeconomic position and lifestyle accounted for 3.4% of variance in carotid intima-media thickness in men and 7.6% in women, compared to 2.2% and 2.0% for early life variables.