Associations between Childhood Body Size, Composition, Blood Pressure and Adult Cardiac Structure: The Fels Longitudinal Study

Abstract

ObjectivesTo determine whether childhood body size, composition and blood pressure are associated with adult cardiac structure by estimating childhood “age of divergence.”Methods385 female and 312 male participants in the Fels Longitudinal Study had echocardiographic measurements of left ventricular mass, relative wall thickness, and interventricular septal thickness. Also available were anthropometric measurements of body mass index, waist circumference, percentage body fat, fat free mass, total body fat, and systolic and diastolic blood pressures, taken in both childhood and adulthood. The age of divergence is estimated as the lowest age at which childhood measurements are significantly different between patients with low and high measurements of adult cardiac structure.ResultsChildhood body mass index is significantly associated with adult left ventricular mass (indexed by height) in men and women (ages of divergence: 7.5 years and 11.5 years, respectively), and with adult interventricular septal thickness in boys (age of divergence: 9 years). Childhood waist circumference indexed by height is associated with left ventricular mass (indexed by height) in boys (age of divergence: 8 years). Cardiac structure was in general not associated with childhood body composition and blood pressure.ConclusionsThough results are affected by adult body size, composition and blood pressure, some aspects of adult cardiac structure may have their genesis in childhood body size.

Hypertension Prevalence, Cardiac Complications, and Antihypertensive Medication Use in Children

“…Although there are insufficient data demonstrating that LVH in children persists into adulthood, there is evidence that childhood hypertension and obesity are associated with adult LVH. 24,25 It seems likely that without proper, timely intervention, children with LVH will become adults with LVH and its attendant risks. Our study confirms that such children are commonly seen in pediatric practice.…”

Body mass index associations between mother and offspring from birth to age 18: the Fels Longitudinal Study

“…Approximately two out of three Americans adults and one in three children are classified as overweight or obese . Chronic diseases such as metabolic syndrome, cardiovascular disease and hypertension, along with mortality in adulthood, are serious health issues that arise from being overweight and obese in childhood . The appearance of chronic diseases during childhood, as a consequence of obesity, is also a major public health concern in the USA .…”

In-Clinic Blood Pressure Prediction of Normal Ambulatory Blood Pressure Monitoring in Pediatric Hypertension Referrals

“…Extending this observation to childhood, investigators from the Bogalusa Heart Study found that children with elevated BMI and elevated BP developed higher LVM in adulthood, but obesity was a stronger predictor (27). Similarly, investigators from the Fels longitudinal study found childhood BMI, but not fat mass or other adiposity indices, predicted future LVH (28). In each of these studies, BMI was a stronger predictor of future LVH than was BP.…”

“…LVH may be related to duration of exposure to hypertension (26–28). Metanalyses show higher LVM values in hypertensive versus normotensive patients (29).…”