The contribution of adolescent cardiovascular disease risk factors to vascular stiffness and cardiac remodelling in young adults.

AIMS: Early identification of abnormalities in vascular and cardiac structure offers an opportunity for intervention to reduce future cardiovascular disease (CVD). This study examined factors contributing to increased CVD risk from adolescence to young adulthood.

METHODS AND RESULTS: Raine Study participants (n = 716) classified as low- or high-CVD risk using cluster analysis at 17 years were re-studied at 27 years. Outcomes at 27 years were vascular stiffness assessed by pulse wave velocity (PWV) and left ventricular mass index (LVMI), left ventricular (LV), right ventricular (RV), and left atrial (LA) myocardial strain and respective ejection fractions (EF) assessed by cardiac magnetic resonance imaging. Outcomes were compared according to low- or high-risk classification at 17 years adjusting for sex and significant covariates at 27 years.At 27 years, individuals classified as high-risk at 17 years had significantly increased PWV (males: 6.6 ± 0.12 vs. 6.2 ± 0.04 m/sec; females: 6.2 ± 0.10 vs. 5.6 ± 0.04 m/sec) and LVMI (males: 75.2 ± 2.1 vs. 69.7 ± 0.5 g/m2; females: 55.4 ± 1.0 vs. 52.1 ± 0.4 g/m2) compared with low-risk individuals. Compared with low-risk individuals, LV global longitudinal strain in high-risk females (-16.7 ± 0.4 vs. -17.6 ± 0.17%, P = 0.041) and LV global circumferential strain in males (-19.1 ± 0.5 vs. -20.5 ± 0.2%, P = 0.013) and females (-21.3 ± 0.4 vs. -22.4 ± 0.2%, P = 0.022) were attenuated. These differences were significant in regression analysis after adjusting for sex and contemporary risk factors.

CONCLUSION: An unhealthy CVD risk profile in adolescence leads to structural vascular and cardiac changes in young adults, predisposing them to future CVD. The results emphasize the importance of early public health measures to reduce the burden of cardiovascular and related lifestyle disorders.