Cumulative Effect of Psychosocial Factors in Youth on Ideal Cardiovascular Health in Adulthood

Abstract

T he American Heart Association (AHA) has defined a new metric of ideal cardiovascular health to accommodate both an expanded emphasis on prevention and greater understanding of the origins of cardiovascular disease as part of its 2020 Impact Goals. The explicit goal of the AHA statement is to improve cardiovascular health of all Americans by 20% by the year 2020 while reducing deaths resulting from cardiovascular diseases and stroke by 20%.1 To monitor progress toward these goals, the AHA has launched a concept of ideal cardiovascular health. This concept is defined by the presence of 7 ideal health factors that describe whether a person has ideal cardiovascular health and indicate where improvement is needed to attain better health.1 Substantial evidence demonstrates that the ideal cardiovascular health index is associated with better vascular health 2 and with reductions in cardiovascular morbidity and mortality. 3,4 Childhood and youth are important stages of life because cardiovascular diseases are rooted in early life 5,6 and socialBackground-The American Heart Association has defined a new metric of ideal cardiovascular health as part of its 2020 Impact Goals. We examined whether psychosocial factors in youth predict ideal cardiovascular health in adulthood. Methods and Results-Participants were 477 men and 612 women from the nationwide Cardiovascular Risk in Young Finns Study. Psychosocial factors were measured from cohorts 3 to 18 years of age at the baseline of the study, and ideal cardiovascular health was examined 27 years later in adulthood. The summary measure of psychosocial factors in youth comprised socioeconomic factors, emotional factors, parental health behaviors, stressful events, self-regulation of the child, and social adjustment of the child. There was a positive association between a higher number of favorable psychosocial factors in youth and greater ideal cardiovascular health index in adulthood (β=0.16; P<0.001) that persisted after adjustment for age, sex, medication use, and cardiovascular risk factors in childhood (β=0.15; P<0.001). The association was monotonic, suggesting that each increment in favorable psychosocial factors was associated with improvement in cardiovascular health. Of the specific psychosocial factors, a favorable socioeconomic environment (β=0.12; P<0.001) and participants' selfregulatory behavior (β=0.07; P=0.004) were the strongest predictors of ideal cardiovascular health in adulthood. Conclusions-The findings suggest a dose-response association between favorable psychosocial factors in youth and cardiovascular health in adulthood, as defined by the American Heart Association metrics. The effect seems to persist throughout the range of cardiovascular health, potentially shifting the population distribution of cardiovascular health rather than simply having effects in a high-risk population. 7 Although the importance of psychosocial factors has been acknowledged, 1,[8][9][10] there remains a lack of knowledge on whether psychosocial factors, emerging already ...

Do Clinical And Psychosocial Factors Affect Health-Related Quality of Life in Adolescents with Chronic Diseases?

“…In addition, it also underlines previous research recommendations, proposing that in the specific period of adolescence Carona, Silva, & Moreira, 2015), it is crucial to include psychosocial dimensions in complement of traditional health indicators (Health, 2013;Watson, 2014, Pulkki-Råback et al, 2015Varni et al, 2007) and to routinely conduct its assessment in clinical and pediatric settings (Mellion et al, 2014;Moreira et al, 2013). Furthermore, to identify the impaired psychosocial domains, can give potentially useful suggestions, that better help to plan and guide interventions aiming to improve an integral perspective that represents the holistic care for these adolescents (Alba et al, 2013;Elsenbruch et al, 2013;Mazur & Małkowska-Szkutnik, 2010;Marmot et al, 2012).…”

“…Supporting this idea, clinical settings have been progressively recognizing the need to complement traditional health indicators with psychosocial factors (Health, 2013;Watson, 2014), which requires a routinely assessment in pediatric contexts (Mellion et al, 2014;Moreira et al, 2013). Moreover, to include such factors in clinical decision making and research is necessary, mainly once to manage symptons and to improve psychosocial care are nowadays primary goals of interventions (Elsenbruch et al, 2013;Health, 2003;Marmot et al, 2012;Pulkki-Råback et al, 2015;Watson, 2014).…”

Preventing Cardiovascular Disease

“…In this issue of Circulation, Pulkki-Råbach et al 4 report that psychosocial factors measured in youth affect cardiovascular health in young adulthood independently of cardiovascular risk factors. The effect was not trivial.…”

Childhood Infections, Socioeconomic Status, and Adult Cardiometabolic Risk

“…[1][2][3] Lower SES is associated with higher prevalence of traditional risk factors 4 and increased cardiometabolic disease prevalence and mortality. 5 The mechanisms by which early life and childhood social disadvantage lead to increased adult cardiometabolic diseases are multifactorial and are suggested to include biological, behavioral, psychological, and social factors. 5 Overall, traditional risk factors do not fully account for the differences in attributable risk.…”

“…5 The mechanisms by which early life and childhood social disadvantage lead to increased adult cardiometabolic diseases are multifactorial and are suggested to include biological, behavioral, psychological, and social factors. 5 Overall, traditional risk factors do not fully account for the differences in attributable risk. 1,6 Increased inflammation throughout the life course is associated with social disadvantage and adverse childhood experiences.…”