Abstract MP43: Disparities in Cardiovascular Health in Childhood: The Young Hearts Study

Introduction: Cardiovascular health (CVH) in childhood is associated with lifetime risk for CVD events. CVH declines with age, and only 50% of US adolescents have 5 of the 7 CVH metrics at ideal levels. Little is known about CVH in young children from diverse backgrounds. The aim of this study is to examine CVH scores by age, gender, race/ethnicity and social determinants of health in a large, diverse cohort of children aged 0-18 years. Methods: The Young Hearts (YH) Study is a pragmatic cohort in which parents and children complete annual surveys on demographics, family and social environment, contextual stress and resilience factors, and behaviors. This survey data will be combined with linked EMR data to provide clinical CVH metrics over time. Behavioral CVH (bCVH) was defined using the AHA’s Life’s Essential 8 (LE8) scoring where individual scores (range 0-100; 80+ is ideal) for each of the 4 health behaviors—diet, physical activity, nicotine exposure, sleep—were assessed using age-specific criteria and then averaged for a composite score. These results represent the first 3,534 participants recruited into the study. Linear regression models examined multivariate predictors of bCVH. Results: Among YH participants (mean age 9.5 years; 53% male, 20% Hispanic, 50% Non-Hispanic White, 18% Non-Hispanic Black, 7% other) the mean bCVH score was 72.5 (33% high CVH range, 60% moderate, 7% low). CVH scores were 96.2 for nicotine exposure, 44.3 for diet, 74.4 for sleep, and 74.8 for physical activity. Scores declined with age and were lowest for Non-Hispanic Black children (Figure). In adjusted models, significant predictors of lower bCVH scores included being Non-Hispanic Black, older age, lower family income, and lower parental education. Conclusion: Among this diverse cohort of children, more than half had non-ideal bCVH scores by a mean age of 9 years. Early primordial prevention efforts are critical to avert the reduction in CVH and eliminate disparities that emerge early in childhood and lead to excess burden of CVD across the lifespan.