Background-The American Heart Association (AHA) defined a new concept, cardiovascular health, and determined metrics needed to monitor it over time as part of its 2020 Impact Goal definition. Ideal cardiovascular health is defined by the presence of both ideal health behaviors and ideal health factors. The applicability of this concept to a cohort of children and its relationship with cardiometabolic outcomes in adulthood has not been reported. Methods and Results-The
Infectious viruses and bacteria can trigger multiple sclerosis (MS) exacerbations. Seasonally changing concentrations of ambient air pollutants are known to predispose to transmissible infections, to induce systemic immune responses and to enhance existing peripheral inflammation. Ambient air quality and monthly MS relapse occurrence in south-western Finland were compared by multivariate logistic regression. The odds ratio of the risk of a relapse onset was over fourfold (4.143, p < 0.001) when the concentration of inhalable particulate matter (PM10) was at the highest quartile. Inhalable airborne particulate matter concentrations were connected to relapse occurrence. Poor air quality may enhance the seasonal changes in MS relapse occurrence by an increased susceptibility to transmissible infections.
Background-Hypertension is a major modifiable cardiovascular risk factor. The present longitudinal study aimed to examine the best combination of childhood physical and environmental factors to predict adult hypertension and furthermore whether newly identified genetic variants for blood pressure increase the prediction of adult hypertension. Methods and Results-The study cohort included 2625 individuals from the Cardiovascular Risk in Young Finns Study who were followed up for 21 to 27 years since baseline (1980; age, 3-18 years). In addition to dietary factors and biomarkers related to blood pressure, we examined whether a genetic risk score based on 29 newly identified single-nucleotide polymorphisms enhances the prediction of adult hypertension. Hypertension in adulthood was defined as systolic blood pressure Ն130 mm Hg and/or diastolic blood pressure Ն85 mm Hg or medication for the condition. Independent childhood risk factors for adult hypertension included the individual's own blood pressure (PϽ0.0001), parental hypertension (PϽ0.0001), childhood overweight/obesity (Pϭ0.005), low parental occupational status (Pϭ0.003), and high genetic risk score (PϽ0.0001). Risk assessment based on childhood overweight/obesity status, parental hypertension, and parental occupational status was superior in predicting hypertension compared with the approach using only data on childhood blood pressure levels (C statistics, 0.718 versus 0.733; Pϭ0.0007). Inclusion of both parental hypertension history and data on novel genetic variants for hypertension further improved the C statistics (0.742; Pϭ0.015). Conclusions-Prediction of adult hypertension was enhanced by taking into account known physical and environmental childhood risk factors, family history of hypertension, and novel genetic variants. A multifactorial approach may be useful in identifying children at high risk for adult hypertension. (Circulation. 2012;126:402-409.)Key Words: blood pressure Ⅲ family Ⅲ genetics Ⅲ hypertension Ⅲ risk assessment H ypertension is one of the major modifiable risk factors for cardiovascular disease with roots in childhood. 1 Early identification of children and adolescents at risk of adult hypertension would allow implementation of prevention strategies earlier in the disease process with the potential to prevent or delay hypertension-related complications. Clinical Perspective on p 409Previous studies have identified several childhood risk factors for adult hypertension. These include overweight and obesity, parental history of hypertension, and low socioeconomic status. [2][3][4][5][6] Blood pressure (BP) has also been shown to Received December 11, 2011; accepted June 1, 2012. In the present study, we have examined in detail which combination of nonlaboratory, laboratory, and family risk factors measured in childhood (at age 3-18 years) best predict adult hypertension (at age 24 -45 years) and whether adding information on novel BP-associated genetic variants enhances early identification of children at risk for adulthood hyperten...
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