Life Course Cardiovascular Health: Risk Factors, Outcomes, and Interventions

Abstract

Since it was first defined by the American Heart Association in 2010, cardiovascular health (CVH) has been extensively studied across the life course. In this review, we present the current literature examining early life predictors of CVH, the later life outcomes of child CVH, and the relatively few interventions which have specifically addressed how to preserve and promote CVH across populations. We find that research on CVH has demonstrated that prenatal and childhood exposures are consistently associated with CVH trajectories from childhood through adulthood. CVH measured at any point in life is strongly predictive of future cardiovascular disease, dementia, cancer, and mortality as well as a variety of other health outcomes. This speaks to the importance of intervening early to prevent the loss of optimal CVH and the accumulation of cardiovascular risk. Interventions to improve CVH are not common but those that have been published most often address multiple modifiable risk factors among individuals within the community. Relatively few interventions have been focused on improving the construct of CVH in children. Future research is needed that will be both effective, scalable, and sustainable. Technology including digital platforms as well as implementation science will play key roles in achieving this vision. In addition, community engagement at all stages of this research is critical. Lastly, prevention strategies that are tailored to the individual and their context may help us achieve the promise of personalized prevention and help promote ideal CVH in childhood and across the life course.

Introduction to the Compendium on Early Cardiovascular Disease

“…The first set of contributions focus on phenotyping the early CVD state. Pedamallu et al 16 set the stage by discussing evidence of CVH trajectories from early life, which track into mid-life, highlighting opportunities to promote CVH in children and young adults. These approaches are complemented by Khan et al, 17 who introduce the concept of pregnancy as a lens into future CVH, issuing a clarion call for a more proactive approach to assessing, monitoring, and modifying CVH throughout pregnancy to affect long-term CVD risk.…”