Childhood Adiposity as a Predictor of Cardiac Mass in Adulthood

BACKGROUND: The association between left ventricular hypertrophy, an independent predictor of cardiovascular (CV) morbidity and mortality, and CV risk factors has been well documented in childhood and in adulthood. However, information on the relationship between left ventricular mass (LVM) in adults and longitudinal measurements of CV risk factors from childhood to adulthood is limited. METHODS AND RESULTS: LVM was obtained with 2D M-mode echocardiography in a community-based sample of 467 young adults (71% white and 29% black) aged 20 to 38 years who were examined an average of 6 times for CV risk factors from childhood to adulthood. The average follow-up period was 21.5 years. The cumulative burden of each risk factor was calculated as the area under the curve for each individual. Compared with whites, blacks had greater LVM (indexed to height(2.7); P<0.05). In multiple regression analyses, adiposity (measured as body mass index) in childhood, adiposity and systolic blood pressure in adulthood, and the cumulative burden of adiposity and systolic blood pressure from childhood to adulthood were significant predictors of LVM index in young adults. CONCLUSIONS: These observations, by showing that adiposity beginning in childhood is a consistent predictor of LVM in young adults, underscore the importance of obesity in the development of left ventricular hypertrophy and the need for early prevention.