Cardiovascular risk factors in British children from towns with widely differing adult cardiovascular mortality

Abstract

Objective-To examine whether cardiovascular risk factors differ in children from towns in England and Wales with widely differing adult cardiovascular death rates.Design-School based survey conducted during 1994 in 10 towns, five with exceptionally high adult cardiovascular mortality (standardised mortality ratio 131-143) and five with exceptionally low adult cardiovascular mortality (64-75). Towns were surveyed in high-low pairs.Subjects-3415 white children aged 8-11 years with physical measurements (response rate 75%), including 1287 with blood samples (response rate 64%), of whom 515 had blood samples taken 30 minutes after a glucose load.Results-Children in towns with high cardiovascular mortality were on average shorter than those in towns with low mortality (mean difference 1.2 cm; 95% confidence interval 0.3 to 2.1 cm; P = 0.02) and had a higher ponderal index (0.34 kg/m3; 0.16 to 0.52 kglm3; P = 0.006). Mean systolic pressure was higher in high mortality towns, particularly after adjustment for height (2.0 mm Hg; 0.8 to 3.2 mm Hg; P = 0.009). Mean waist:hip ratio, total cholesterol concentration, and 30 minute post-load glucose measurements were similar in high and low mortality towns. The differences in height and blood pressure between high and low mortality towns were unaffected by standardisation for birth weight.Conclusions-The differences in height, ponderal index, and blood pressure between towns with high and low cardiovascular mortality, ifpersistent, may have important future public health implications. Their independence of birth weight suggests that the childhood environment rather than the intrauterine environment is involved in their development. IntroductionThe geographic variation in mortality from cardiovascular disease across Great Britain, with the lowest rates in the south east and the highest in south Wales, northern England, and Scotland, is well described' but

Relationship between anthropometric variables and lipid levels among school children: The Taipei Children Heart Study

“…Although WHR is also associated with lipid concentrations and not all skinfold measurements may be equally informative, subscapular skinfold measures are generally stronger and more consistently predict lipid levels. 3,4,10,36 In the Bogalusa Heart Study 15 , truncal skinfolds such as subscapular and suprailiac measurements were more strongly correlated with total cholesterol and HDL-C than peripheral skinfolds. Others have reported that several skinfold measurements and ratios of these indices (subscapularatriceps ratio) are positively correlated with TG and ApoB concentrations and negatively correlated with HDL-C in children and adults.…”

“…Body height was an important predictor for lower total cholesterol, LDL-C and ApoB levels among boys in this and other studies. 35,36 Height may be a surrogate for adequate nutrition in infancy and childhood development. Regardless of the underlying physiological effects of height, these data suggest that the reduced risk of coronary heart disease among taller adult men and women, 31,37 may be traceable to the association between height and lipids among adolescents.…”

Childhood size is more strongly related than size at birth to glucose and insulin levels in 10-11-year-old children

“…Details of this survey of cardiovascular risk factors in children have been published elsewhere [17]. The study took place in ten towns in England and Wales -five with exceptionally low adult cardiovascular mortality rates (Esher, Leatherhead, Bath, Chelmsford, Tunbridge Wells) and five with exceptionally high adult cardiovascular mortality rates (Wigan, Port Talbot, Burnley, Rochdale, Rhondda).…”

Dietary patterns among children aged 6–7 y in four Spanish cities with widely differing cardiovascular mortality

“…Among possible mechanisms for these findings, there is the association of low weight and length at birth, and a reduced rate of intra-uterus and infant development, with cardiovascular risk factors in adulthood, such as plasma concentrations of cholesterol, apolipoprotein B Barker et al, 1993) and fibrinogen , blood pressure (Hales et al, 1991;Barker et al, 1990), body fat distribution (central obesity; Law et al, 1992), glucose intolerance and diabetes (Hales et al, 1991). Furthermore, a recent study has shown that British 8 -11 y-olds from five cities with exceptionally high cardiovascular mortality were shorter in stature and had a higher ponderal index (weight=height) 3 and blood pressure than those from five cities with exceptionally low cardiovascular mortality (Whincup et al, 1996). This study examines a number of anthropometric variables and the consumption of principal foods and nutrients among children aged 6 -7 y, living in four Spanish cities with a substantial variation in IHD mortality.…”