Childhood Cardiovascular Risk Factors and Adult Cardiovascular Events

In this study, childhood cardiovascular risk factors including BMI, systolic blood pressure, lipid levels, and smoking were correlated with cardiovascular events in adulthood after a mean follow-up of 35 years. Childhood risk factors and the change in risk score between childhood and adulthood were...

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Published inThe New England journal of medicine Vol. 386; no. 20; pp. 1877 - 1888
Main Authors Jacobs, David R., Woo, Jessica G., Sinaiko, Alan R., Daniels, Stephen R., Ikonen, Johanna, Juonala, Markus, Kartiosuo, Noora, Lehtimäki, Terho, Magnussen, Costan G., Viikari, Jorma S.A., Zhang, Nanhua, Bazzano, Lydia A., Burns, Trudy L., Prineas, Ronald J., Steinberger, Julia, Urbina, Elaine M., Venn, Alison J., Raitakari, Olli T., Dwyer, Terence
Format Journal Article
LanguageEnglish
Published United States Massachusetts Medical Society 19.05.2022
Subjects
Online AccessGet full text
ISSN0028-4793
1533-4406
1533-4406
DOI10.1056/NEJMoa2109191

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Abstract In this study, childhood cardiovascular risk factors including BMI, systolic blood pressure, lipid levels, and smoking were correlated with cardiovascular events in adulthood after a mean follow-up of 35 years. Childhood risk factors and the change in risk score between childhood and adulthood were associated with midlife cardiovascular events.
AbstractList Childhood cardiovascular risk factors predict subclinical adult cardiovascular disease, but links to clinical events are unclear. In a prospective cohort study involving participants in the International Childhood Cardiovascular Cohort (i3C) Consortium, we evaluated whether childhood risk factors (at the ages of 3 to 19 years) were associated with cardiovascular events in adulthood after a mean follow-up of 35 years. Body-mass index, systolic blood pressure, total cholesterol level, triglyceride level, and youth smoking were analyzed with the use of i3C-derived age- and sex-specific z scores and with a combined-risk z score that was calculated as the unweighted mean of the five risk z scores. An algebraically comparable adult combined-risk z score (before any cardiovascular event) was analyzed jointly with the childhood risk factors. Study outcomes were fatal cardiovascular events and fatal or nonfatal cardiovascular events, and analyses were performed after multiple imputation with the use of proportional-hazards regression. In the analysis of 319 fatal cardiovascular events that occurred among 38,589 participants (49.7% male and 15.0% Black; mean [±SD] age at childhood visits, 11.8±3.1 years), the hazard ratios for a fatal cardiovascular event in adulthood ranged from 1.30 (95% confidence interval [CI], 1.14 to 1.47) per unit increase in the z score for total cholesterol level to 1.61 (95% CI, 1.21 to 2.13) for youth smoking (yes vs. no). The hazard ratio for a fatal cardiovascular event with respect to the combined-risk z score was 2.71 (95% CI, 2.23 to 3.29) per unit increase. The hazard ratios and their 95% confidence intervals in the analyses of fatal cardiovascular events were similar to those in the analyses of 779 fatal or nonfatal cardiovascular events that occurred among 20,656 participants who could be evaluated for this outcome. In the analysis of 115 fatal cardiovascular events that occurred in a subgroup of 13,401 participants (31.0±5.6 years of age at the adult measurement) who had data on adult risk factors, the adjusted hazard ratio with respect to the childhood combined-risk z score was 3.54 (95% CI, 2.57 to 4.87) per unit increase, and the mutually adjusted hazard ratio with respect to the change in the combined-risk z score from childhood to adulthood was 2.88 (95% CI, 2.06 to 4.05) per unit increase. The results were similar in the analysis of 524 fatal or nonfatal cardiovascular events. In this prospective cohort study, childhood risk factors and the change in the combined-risk z score between childhood and adulthood were associated with cardiovascular events in midlife. (Funded by the National Institutes of Health.).
Childhood cardiovascular risk factors predict subclinical adult cardiovascular disease, but links to clinical events are unclear.BACKGROUNDChildhood cardiovascular risk factors predict subclinical adult cardiovascular disease, but links to clinical events are unclear.In a prospective cohort study involving participants in the International Childhood Cardiovascular Cohort (i3C) Consortium, we evaluated whether childhood risk factors (at the ages of 3 to 19 years) were associated with cardiovascular events in adulthood after a mean follow-up of 35 years. Body-mass index, systolic blood pressure, total cholesterol level, triglyceride level, and youth smoking were analyzed with the use of i3C-derived age- and sex-specific z scores and with a combined-risk z score that was calculated as the unweighted mean of the five risk z scores. An algebraically comparable adult combined-risk z score (before any cardiovascular event) was analyzed jointly with the childhood risk factors. Study outcomes were fatal cardiovascular events and fatal or nonfatal cardiovascular events, and analyses were performed after multiple imputation with the use of proportional-hazards regression.METHODSIn a prospective cohort study involving participants in the International Childhood Cardiovascular Cohort (i3C) Consortium, we evaluated whether childhood risk factors (at the ages of 3 to 19 years) were associated with cardiovascular events in adulthood after a mean follow-up of 35 years. Body-mass index, systolic blood pressure, total cholesterol level, triglyceride level, and youth smoking were analyzed with the use of i3C-derived age- and sex-specific z scores and with a combined-risk z score that was calculated as the unweighted mean of the five risk z scores. An algebraically comparable adult combined-risk z score (before any cardiovascular event) was analyzed jointly with the childhood risk factors. Study outcomes were fatal cardiovascular events and fatal or nonfatal cardiovascular events, and analyses were performed after multiple imputation with the use of proportional-hazards regression.In the analysis of 319 fatal cardiovascular events that occurred among 38,589 participants (49.7% male and 15.0% Black; mean [±SD] age at childhood visits, 11.8±3.1 years), the hazard ratios for a fatal cardiovascular event in adulthood ranged from 1.30 (95% confidence interval [CI], 1.14 to 1.47) per unit increase in the z score for total cholesterol level to 1.61 (95% CI, 1.21 to 2.13) for youth smoking (yes vs. no). The hazard ratio for a fatal cardiovascular event with respect to the combined-risk z score was 2.71 (95% CI, 2.23 to 3.29) per unit increase. The hazard ratios and their 95% confidence intervals in the analyses of fatal cardiovascular events were similar to those in the analyses of 779 fatal or nonfatal cardiovascular events that occurred among 20,656 participants who could be evaluated for this outcome. In the analysis of 115 fatal cardiovascular events that occurred in a subgroup of 13,401 participants (31.0±5.6 years of age at the adult measurement) who had data on adult risk factors, the adjusted hazard ratio with respect to the childhood combined-risk z score was 3.54 (95% CI, 2.57 to 4.87) per unit increase, and the mutually adjusted hazard ratio with respect to the change in the combined-risk z score from childhood to adulthood was 2.88 (95% CI, 2.06 to 4.05) per unit increase. The results were similar in the analysis of 524 fatal or nonfatal cardiovascular events.RESULTSIn the analysis of 319 fatal cardiovascular events that occurred among 38,589 participants (49.7% male and 15.0% Black; mean [±SD] age at childhood visits, 11.8±3.1 years), the hazard ratios for a fatal cardiovascular event in adulthood ranged from 1.30 (95% confidence interval [CI], 1.14 to 1.47) per unit increase in the z score for total cholesterol level to 1.61 (95% CI, 1.21 to 2.13) for youth smoking (yes vs. no). The hazard ratio for a fatal cardiovascular event with respect to the combined-risk z score was 2.71 (95% CI, 2.23 to 3.29) per unit increase. The hazard ratios and their 95% confidence intervals in the analyses of fatal cardiovascular events were similar to those in the analyses of 779 fatal or nonfatal cardiovascular events that occurred among 20,656 participants who could be evaluated for this outcome. In the analysis of 115 fatal cardiovascular events that occurred in a subgroup of 13,401 participants (31.0±5.6 years of age at the adult measurement) who had data on adult risk factors, the adjusted hazard ratio with respect to the childhood combined-risk z score was 3.54 (95% CI, 2.57 to 4.87) per unit increase, and the mutually adjusted hazard ratio with respect to the change in the combined-risk z score from childhood to adulthood was 2.88 (95% CI, 2.06 to 4.05) per unit increase. The results were similar in the analysis of 524 fatal or nonfatal cardiovascular events.In this prospective cohort study, childhood risk factors and the change in the combined-risk z score between childhood and adulthood were associated with cardiovascular events in midlife. (Funded by the National Institutes of Health.).CONCLUSIONSIn this prospective cohort study, childhood risk factors and the change in the combined-risk z score between childhood and adulthood were associated with cardiovascular events in midlife. (Funded by the National Institutes of Health.).
AbstractBackgroundChildhood cardiovascular risk factors predict subclinical adult cardiovascular disease, but links to clinical events are unclear.MethodsIn a prospective cohort study involving participants in the International Childhood Cardiovascular Cohort (i3C) Consortium, we evaluated whether childhood risk factors (at the ages of 3 to 19 years) were associated with cardiovascular events in adulthood after a mean follow-up of 35 years. Body-mass index, systolic blood pressure, total cholesterol level, triglyceride level, and youth smoking were analyzed with the use of i3C-derived age- and sex-specific z scores and with a combined-risk z score that was calculated as the unweighted mean of the five risk z scores. An algebraically comparable adult combined-risk z score (before any cardiovascular event) was analyzed jointly with the childhood risk factors. Study outcomes were fatal cardiovascular events and fatal or nonfatal cardiovascular events, and analyses were performed after multiple imputation with the use of proportional-hazards regression.ResultsIn the analysis of 319 fatal cardiovascular events that occurred among 38,589 participants (49.7% male and 15.0% Black; mean [±SD] age at childhood visits, 11.8±3.1 years), the hazard ratios for a fatal cardiovascular event in adulthood ranged from 1.30 (95% confidence interval [CI], 1.14 to 1.47) per unit increase in the z score for total cholesterol level to 1.61 (95% CI, 1.21 to 2.13) for youth smoking (yes vs. no). The hazard ratio for a fatal cardiovascular event with respect to the combined-risk z score was 2.71 (95% CI, 2.23 to 3.29) per unit increase. The hazard ratios and their 95% confidence intervals in the analyses of fatal cardiovascular events were similar to those in the analyses of 779 fatal or nonfatal cardiovascular events that occurred among 20,656 participants who could be evaluated for this outcome. In the analysis of 115 fatal cardiovascular events that occurred in a subgroup of 13,401 participants (31.0±5.6 years of age at the adult measurement) who had data on adult risk factors, the adjusted hazard ratio with respect to the childhood combined-risk z score was 3.54 (95% CI, 2.57 to 4.87) per unit increase, and the mutually adjusted hazard ratio with respect to the change in the combined-risk z score from childhood to adulthood was 2.88 (95% CI, 2.06 to 4.05) per unit increase. The results were similar in the analysis of 524 fatal or nonfatal cardiovascular events.ConclusionsIn this prospective cohort study, childhood risk factors and the change in the combined-risk z score between childhood and adulthood were associated with cardiovascular events in midlife. (Funded by the National Institutes of Health.)
In this study, childhood cardiovascular risk factors including BMI, systolic blood pressure, lipid levels, and smoking were correlated with cardiovascular events in adulthood after a mean follow-up of 35 years. Childhood risk factors and the change in risk score between childhood and adulthood were associated with midlife cardiovascular events.
Author Burns, Trudy L.
Kartiosuo, Noora
Woo, Jessica G.
Viikari, Jorma S.A.
Zhang, Nanhua
Venn, Alison J.
Juonala, Markus
Magnussen, Costan G.
Steinberger, Julia
Daniels, Stephen R.
Prineas, Ronald J.
Urbina, Elaine M.
Lehtimäki, Terho
Sinaiko, Alan R.
Raitakari, Olli T.
Jacobs, David R.
Ikonen, Johanna
Bazzano, Lydia A.
Dwyer, Terence
Author_xml – sequence: 1
  givenname: David R.
  surname: Jacobs
  fullname: Jacobs, David R.
  organization: From the Division of Epidemiology and Community Health, School of Public Health (D.R.J.), and the Department of Pediatrics, University of Minnesota Medical School (A.R.S., J.S.), University of Minnesota, Minneapolis; the Division of Biostatistics and Epidemiology (J.G.W., N.Z.), and the Heart Institute (E.M.U.), Cincinnati Children’s Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine (J.G.W., N.Z., E.M.U.) — both in Cincinnati; the Department of Pediatrics, University of Colorado School of Medicine, and Anschutz Medical Campus, Children’s Hospital Colorado — both in Aurora (S.R.D.); the Center for Population Health Research (J.I., N.K., C.G.M., O.T.R.), the Research Center of Applied and Preventive Cardiovascular Medicine (J.I., N.K., C.G.M., O.T.R.), and the Departments of Medicine (M.J., J.S.A.V.) and Mathematics and Statistics (N.K.), University of Turku, and the Center for Population Health Research (J.I., N.K., C.G.M., O.T.R.), the Division of Medicine (M.J., J.S.A.V.), and the Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital, Turku, and the Department of Clinical Chemistry, Fimlab Laboratories, and the Finnish Cardiovascular Research Center, and the Faculty of Medicine and Health Technology, Tampere University, Tampere (T.L.) — all in Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS (C.G.M., A.J.V., T.D.), and the Heart Research Group, Murdoch Children’s Research Institute, Melbourne, VIC (T.D.) — both in Australia; the School of Public Health and Tropical Medicine, Tulane University, New Orleans (L.A.B.); the Department of Epidemiology, College of Public Health, University of Iowa, Iowa City (T.L.B.); the Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC (R.J.P.); and the Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom (T.D.)
– sequence: 2
  givenname: Jessica G.
  surname: Woo
  fullname: Woo, Jessica G.
  organization: From the Division of Epidemiology and Community Health, School of Public Health (D.R.J.), and the Department of Pediatrics, University of Minnesota Medical School (A.R.S., J.S.), University of Minnesota, Minneapolis; the Division of Biostatistics and Epidemiology (J.G.W., N.Z.), and the Heart Institute (E.M.U.), Cincinnati Children’s Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine (J.G.W., N.Z., E.M.U.) — both in Cincinnati; the Department of Pediatrics, University of Colorado School of Medicine, and Anschutz Medical Campus, Children’s Hospital Colorado — both in Aurora (S.R.D.); the Center for Population Health Research (J.I., N.K., C.G.M., O.T.R.), the Research Center of Applied and Preventive Cardiovascular Medicine (J.I., N.K., C.G.M., O.T.R.), and the Departments of Medicine (M.J., J.S.A.V.) and Mathematics and Statistics (N.K.), University of Turku, and the Center for Population Health Research (J.I., N.K., C.G.M., O.T.R.), the Division of Medicine (M.J., J.S.A.V.), and the Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital, Turku, and the Department of Clinical Chemistry, Fimlab Laboratories, and the Finnish Cardiovascular Research Center, and the Faculty of Medicine and Health Technology, Tampere University, Tampere (T.L.) — all in Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS (C.G.M., A.J.V., T.D.), and the Heart Research Group, Murdoch Children’s Research Institute, Melbourne, VIC (T.D.) — both in Australia; the School of Public Health and Tropical Medicine, Tulane University, New Orleans (L.A.B.); the Department of Epidemiology, College of Public Health, University of Iowa, Iowa City (T.L.B.); the Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC (R.J.P.); and the Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom (T.D.)
– sequence: 3
  givenname: Alan R.
  surname: Sinaiko
  fullname: Sinaiko, Alan R.
  organization: From the Division of Epidemiology and Community Health, School of Public Health (D.R.J.), and the Department of Pediatrics, University of Minnesota Medical School (A.R.S., J.S.), University of Minnesota, Minneapolis; the Division of Biostatistics and Epidemiology (J.G.W., N.Z.), and the Heart Institute (E.M.U.), Cincinnati Children’s Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine (J.G.W., N.Z., E.M.U.) — both in Cincinnati; the Department of Pediatrics, University of Colorado School of Medicine, and Anschutz Medical Campus, Children’s Hospital Colorado — both in Aurora (S.R.D.); the Center for Population Health Research (J.I., N.K., C.G.M., O.T.R.), the Research Center of Applied and Preventive Cardiovascular Medicine (J.I., N.K., C.G.M., O.T.R.), and the Departments of Medicine (M.J., J.S.A.V.) and Mathematics and Statistics (N.K.), University of Turku, and the Center for Population Health Research (J.I., N.K., C.G.M., O.T.R.), the Division of Medicine (M.J., J.S.A.V.), and the Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital, Turku, and the Department of Clinical Chemistry, Fimlab Laboratories, and the Finnish Cardiovascular Research Center, and the Faculty of Medicine and Health Technology, Tampere University, Tampere (T.L.) — all in Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS (C.G.M., A.J.V., T.D.), and the Heart Research Group, Murdoch Children’s Research Institute, Melbourne, VIC (T.D.) — both in Australia; the School of Public Health and Tropical Medicine, Tulane University, New Orleans (L.A.B.); the Department of Epidemiology, College of Public Health, University of Iowa, Iowa City (T.L.B.); the Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC (R.J.P.); and the Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom (T.D.)
– sequence: 4
  givenname: Stephen R.
  surname: Daniels
  fullname: Daniels, Stephen R.
  organization: From the Division of Epidemiology and Community Health, School of Public Health (D.R.J.), and the Department of Pediatrics, University of Minnesota Medical School (A.R.S., J.S.), University of Minnesota, Minneapolis; the Division of Biostatistics and Epidemiology (J.G.W., N.Z.), and the Heart Institute (E.M.U.), Cincinnati Children’s Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine (J.G.W., N.Z., E.M.U.) — both in Cincinnati; the Department of Pediatrics, University of Colorado School of Medicine, and Anschutz Medical Campus, Children’s Hospital Colorado — both in Aurora (S.R.D.); the Center for Population Health Research (J.I., N.K., C.G.M., O.T.R.), the Research Center of Applied and Preventive Cardiovascular Medicine (J.I., N.K., C.G.M., O.T.R.), and the Departments of Medicine (M.J., J.S.A.V.) and Mathematics and Statistics (N.K.), University of Turku, and the Center for Population Health Research (J.I., N.K., C.G.M., O.T.R.), the Division of Medicine (M.J., J.S.A.V.), and the Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital, Turku, and the Department of Clinical Chemistry, Fimlab Laboratories, and the Finnish Cardiovascular Research Center, and the Faculty of Medicine and Health Technology, Tampere University, Tampere (T.L.) — all in Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS (C.G.M., A.J.V., T.D.), and the Heart Research Group, Murdoch Children’s Research Institute, Melbourne, VIC (T.D.) — both in Australia; the School of Public Health and Tropical Medicine, Tulane University, New Orleans (L.A.B.); the Department of Epidemiology, College of Public Health, University of Iowa, Iowa City (T.L.B.); the Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC (R.J.P.); and the Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom (T.D.)
– sequence: 5
  givenname: Johanna
  surname: Ikonen
  fullname: Ikonen, Johanna
  organization: From the Division of Epidemiology and Community Health, School of Public Health (D.R.J.), and the Department of Pediatrics, University of Minnesota Medical School (A.R.S., J.S.), University of Minnesota, Minneapolis; the Division of Biostatistics and Epidemiology (J.G.W., N.Z.), and the Heart Institute (E.M.U.), Cincinnati Children’s Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine (J.G.W., N.Z., E.M.U.) — both in Cincinnati; the Department of Pediatrics, University of Colorado School of Medicine, and Anschutz Medical Campus, Children’s Hospital Colorado — both in Aurora (S.R.D.); the Center for Population Health Research (J.I., N.K., C.G.M., O.T.R.), the Research Center of Applied and Preventive Cardiovascular Medicine (J.I., N.K., C.G.M., O.T.R.), and the Departments of Medicine (M.J., J.S.A.V.) and Mathematics and Statistics (N.K.), University of Turku, and the Center for Population Health Research (J.I., N.K., C.G.M., O.T.R.), the Division of Medicine (M.J., J.S.A.V.), and the Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital, Turku, and the Department of Clinical Chemistry, Fimlab Laboratories, and the Finnish Cardiovascular Research Center, and the Faculty of Medicine and Health Technology, Tampere University, Tampere (T.L.) — all in Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS (C.G.M., A.J.V., T.D.), and the Heart Research Group, Murdoch Children’s Research Institute, Melbourne, VIC (T.D.) — both in Australia; the School of Public Health and Tropical Medicine, Tulane University, New Orleans (L.A.B.); the Department of Epidemiology, College of Public Health, University of Iowa, Iowa City (T.L.B.); the Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC (R.J.P.); and the Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom (T.D.)
– sequence: 6
  givenname: Markus
  surname: Juonala
  fullname: Juonala, Markus
  organization: From the Division of Epidemiology and Community Health, School of Public Health (D.R.J.), and the Department of Pediatrics, University of Minnesota Medical School (A.R.S., J.S.), University of Minnesota, Minneapolis; the Division of Biostatistics and Epidemiology (J.G.W., N.Z.), and the Heart Institute (E.M.U.), Cincinnati Children’s Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine (J.G.W., N.Z., E.M.U.) — both in Cincinnati; the Department of Pediatrics, University of Colorado School of Medicine, and Anschutz Medical Campus, Children’s Hospital Colorado — both in Aurora (S.R.D.); the Center for Population Health Research (J.I., N.K., C.G.M., O.T.R.), the Research Center of Applied and Preventive Cardiovascular Medicine (J.I., N.K., C.G.M., O.T.R.), and the Departments of Medicine (M.J., J.S.A.V.) and Mathematics and Statistics (N.K.), University of Turku, and the Center for Population Health Research (J.I., N.K., C.G.M., O.T.R.), the Division of Medicine (M.J., J.S.A.V.), and the Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital, Turku, and the Department of Clinical Chemistry, Fimlab Laboratories, and the Finnish Cardiovascular Research Center, and the Faculty of Medicine and Health Technology, Tampere University, Tampere (T.L.) — all in Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS (C.G.M., A.J.V., T.D.), and the Heart Research Group, Murdoch Children’s Research Institute, Melbourne, VIC (T.D.) — both in Australia; the School of Public Health and Tropical Medicine, Tulane University, New Orleans (L.A.B.); the Department of Epidemiology, College of Public Health, University of Iowa, Iowa City (T.L.B.); the Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC (R.J.P.); and the Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom (T.D.)
– sequence: 7
  givenname: Noora
  surname: Kartiosuo
  fullname: Kartiosuo, Noora
  organization: From the Division of Epidemiology and Community Health, School of Public Health (D.R.J.), and the Department of Pediatrics, University of Minnesota Medical School (A.R.S., J.S.), University of Minnesota, Minneapolis; the Division of Biostatistics and Epidemiology (J.G.W., N.Z.), and the Heart Institute (E.M.U.), Cincinnati Children’s Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine (J.G.W., N.Z., E.M.U.) — both in Cincinnati; the Department of Pediatrics, University of Colorado School of Medicine, and Anschutz Medical Campus, Children’s Hospital Colorado — both in Aurora (S.R.D.); the Center for Population Health Research (J.I., N.K., C.G.M., O.T.R.), the Research Center of Applied and Preventive Cardiovascular Medicine (J.I., N.K., C.G.M., O.T.R.), and the Departments of Medicine (M.J., J.S.A.V.) and Mathematics and Statistics (N.K.), University of Turku, and the Center for Population Health Research (J.I., N.K., C.G.M., O.T.R.), the Division of Medicine (M.J., J.S.A.V.), and the Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital, Turku, and the Department of Clinical Chemistry, Fimlab Laboratories, and the Finnish Cardiovascular Research Center, and the Faculty of Medicine and Health Technology, Tampere University, Tampere (T.L.) — all in Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS (C.G.M., A.J.V., T.D.), and the Heart Research Group, Murdoch Children’s Research Institute, Melbourne, VIC (T.D.) — both in Australia; the School of Public Health and Tropical Medicine, Tulane University, New Orleans (L.A.B.); the Department of Epidemiology, College of Public Health, University of Iowa, Iowa City (T.L.B.); the Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC (R.J.P.); and the Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom (T.D.)
– sequence: 8
  givenname: Terho
  surname: Lehtimäki
  fullname: Lehtimäki, Terho
  organization: From the Division of Epidemiology and Community Health, School of Public Health (D.R.J.), and the Department of Pediatrics, University of Minnesota Medical School (A.R.S., J.S.), University of Minnesota, Minneapolis; the Division of Biostatistics and Epidemiology (J.G.W., N.Z.), and the Heart Institute (E.M.U.), Cincinnati Children’s Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine (J.G.W., N.Z., E.M.U.) — both in Cincinnati; the Department of Pediatrics, University of Colorado School of Medicine, and Anschutz Medical Campus, Children’s Hospital Colorado — both in Aurora (S.R.D.); the Center for Population Health Research (J.I., N.K., C.G.M., O.T.R.), the Research Center of Applied and Preventive Cardiovascular Medicine (J.I., N.K., C.G.M., O.T.R.), and the Departments of Medicine (M.J., J.S.A.V.) and Mathematics and Statistics (N.K.), University of Turku, and the Center for Population Health Research (J.I., N.K., C.G.M., O.T.R.), the Division of Medicine (M.J., J.S.A.V.), and the Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital, Turku, and the Department of Clinical Chemistry, Fimlab Laboratories, and the Finnish Cardiovascular Research Center, and the Faculty of Medicine and Health Technology, Tampere University, Tampere (T.L.) — all in Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS (C.G.M., A.J.V., T.D.), and the Heart Research Group, Murdoch Children’s Research Institute, Melbourne, VIC (T.D.) — both in Australia; the School of Public Health and Tropical Medicine, Tulane University, New Orleans (L.A.B.); the Department of Epidemiology, College of Public Health, University of Iowa, Iowa City (T.L.B.); the Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC (R.J.P.); and the Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom (T.D.)
– sequence: 9
  givenname: Costan G.
  surname: Magnussen
  fullname: Magnussen, Costan G.
  organization: From the Division of Epidemiology and Community Health, School of Public Health (D.R.J.), and the Department of Pediatrics, University of Minnesota Medical School (A.R.S., J.S.), University of Minnesota, Minneapolis; the Division of Biostatistics and Epidemiology (J.G.W., N.Z.), and the Heart Institute (E.M.U.), Cincinnati Children’s Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine (J.G.W., N.Z., E.M.U.) — both in Cincinnati; the Department of Pediatrics, University of Colorado School of Medicine, and Anschutz Medical Campus, Children’s Hospital Colorado — both in Aurora (S.R.D.); the Center for Population Health Research (J.I., N.K., C.G.M., O.T.R.), the Research Center of Applied and Preventive Cardiovascular Medicine (J.I., N.K., C.G.M., O.T.R.), and the Departments of Medicine (M.J., J.S.A.V.) and Mathematics and Statistics (N.K.), University of Turku, and the Center for Population Health Research (J.I., N.K., C.G.M., O.T.R.), the Division of Medicine (M.J., J.S.A.V.), and the Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital, Turku, and the Department of Clinical Chemistry, Fimlab Laboratories, and the Finnish Cardiovascular Research Center, and the Faculty of Medicine and Health Technology, Tampere University, Tampere (T.L.) — all in Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS (C.G.M., A.J.V., T.D.), and the Heart Research Group, Murdoch Children’s Research Institute, Melbourne, VIC (T.D.) — both in Australia; the School of Public Health and Tropical Medicine, Tulane University, New Orleans (L.A.B.); the Department of Epidemiology, College of Public Health, University of Iowa, Iowa City (T.L.B.); the Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC (R.J.P.); and the Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom (T.D.)
– sequence: 10
  givenname: Jorma S.A.
  surname: Viikari
  fullname: Viikari, Jorma S.A.
  organization: From the Division of Epidemiology and Community Health, School of Public Health (D.R.J.), and the Department of Pediatrics, University of Minnesota Medical School (A.R.S., J.S.), University of Minnesota, Minneapolis; the Division of Biostatistics and Epidemiology (J.G.W., N.Z.), and the Heart Institute (E.M.U.), Cincinnati Children’s Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine (J.G.W., N.Z., E.M.U.) — both in Cincinnati; the Department of Pediatrics, University of Colorado School of Medicine, and Anschutz Medical Campus, Children’s Hospital Colorado — both in Aurora (S.R.D.); the Center for Population Health Research (J.I., N.K., C.G.M., O.T.R.), the Research Center of Applied and Preventive Cardiovascular Medicine (J.I., N.K., C.G.M., O.T.R.), and the Departments of Medicine (M.J., J.S.A.V.) and Mathematics and Statistics (N.K.), University of Turku, and the Center for Population Health Research (J.I., N.K., C.G.M., O.T.R.), the Division of Medicine (M.J., J.S.A.V.), and the Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital, Turku, and the Department of Clinical Chemistry, Fimlab Laboratories, and the Finnish Cardiovascular Research Center, and the Faculty of Medicine and Health Technology, Tampere University, Tampere (T.L.) — all in Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS (C.G.M., A.J.V., T.D.), and the Heart Research Group, Murdoch Children’s Research Institute, Melbourne, VIC (T.D.) — both in Australia; the School of Public Health and Tropical Medicine, Tulane University, New Orleans (L.A.B.); the Department of Epidemiology, College of Public Health, University of Iowa, Iowa City (T.L.B.); the Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC (R.J.P.); and the Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom (T.D.)
– sequence: 11
  givenname: Nanhua
  surname: Zhang
  fullname: Zhang, Nanhua
  organization: From the Division of Epidemiology and Community Health, School of Public Health (D.R.J.), and the Department of Pediatrics, University of Minnesota Medical School (A.R.S., J.S.), University of Minnesota, Minneapolis; the Division of Biostatistics and Epidemiology (J.G.W., N.Z.), and the Heart Institute (E.M.U.), Cincinnati Children’s Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine (J.G.W., N.Z., E.M.U.) — both in Cincinnati; the Department of Pediatrics, University of Colorado School of Medicine, and Anschutz Medical Campus, Children’s Hospital Colorado — both in Aurora (S.R.D.); the Center for Population Health Research (J.I., N.K., C.G.M., O.T.R.), the Research Center of Applied and Preventive Cardiovascular Medicine (J.I., N.K., C.G.M., O.T.R.), and the Departments of Medicine (M.J., J.S.A.V.) and Mathematics and Statistics (N.K.), University of Turku, and the Center for Population Health Research (J.I., N.K., C.G.M., O.T.R.), the Division of Medicine (M.J., J.S.A.V.), and the Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital, Turku, and the Department of Clinical Chemistry, Fimlab Laboratories, and the Finnish Cardiovascular Research Center, and the Faculty of Medicine and Health Technology, Tampere University, Tampere (T.L.) — all in Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS (C.G.M., A.J.V., T.D.), and the Heart Research Group, Murdoch Children’s Research Institute, Melbourne, VIC (T.D.) — both in Australia; the School of Public Health and Tropical Medicine, Tulane University, New Orleans (L.A.B.); the Department of Epidemiology, College of Public Health, University of Iowa, Iowa City (T.L.B.); the Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC (R.J.P.); and the Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom (T.D.)
– sequence: 12
  givenname: Lydia A.
  surname: Bazzano
  fullname: Bazzano, Lydia A.
  organization: From the Division of Epidemiology and Community Health, School of Public Health (D.R.J.), and the Department of Pediatrics, University of Minnesota Medical School (A.R.S., J.S.), University of Minnesota, Minneapolis; the Division of Biostatistics and Epidemiology (J.G.W., N.Z.), and the Heart Institute (E.M.U.), Cincinnati Children’s Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine (J.G.W., N.Z., E.M.U.) — both in Cincinnati; the Department of Pediatrics, University of Colorado School of Medicine, and Anschutz Medical Campus, Children’s Hospital Colorado — both in Aurora (S.R.D.); the Center for Population Health Research (J.I., N.K., C.G.M., O.T.R.), the Research Center of Applied and Preventive Cardiovascular Medicine (J.I., N.K., C.G.M., O.T.R.), and the Departments of Medicine (M.J., J.S.A.V.) and Mathematics and Statistics (N.K.), University of Turku, and the Center for Population Health Research (J.I., N.K., C.G.M., O.T.R.), the Division of Medicine (M.J., J.S.A.V.), and the Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital, Turku, and the Department of Clinical Chemistry, Fimlab Laboratories, and the Finnish Cardiovascular Research Center, and the Faculty of Medicine and Health Technology, Tampere University, Tampere (T.L.) — all in Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS (C.G.M., A.J.V., T.D.), and the Heart Research Group, Murdoch Children’s Research Institute, Melbourne, VIC (T.D.) — both in Australia; the School of Public Health and Tropical Medicine, Tulane University, New Orleans (L.A.B.); the Department of Epidemiology, College of Public Health, University of Iowa, Iowa City (T.L.B.); the Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC (R.J.P.); and the Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom (T.D.)
– sequence: 13
  givenname: Trudy L.
  surname: Burns
  fullname: Burns, Trudy L.
  organization: From the Division of Epidemiology and Community Health, School of Public Health (D.R.J.), and the Department of Pediatrics, University of Minnesota Medical School (A.R.S., J.S.), University of Minnesota, Minneapolis; the Division of Biostatistics and Epidemiology (J.G.W., N.Z.), and the Heart Institute (E.M.U.), Cincinnati Children’s Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine (J.G.W., N.Z., E.M.U.) — both in Cincinnati; the Department of Pediatrics, University of Colorado School of Medicine, and Anschutz Medical Campus, Children’s Hospital Colorado — both in Aurora (S.R.D.); the Center for Population Health Research (J.I., N.K., C.G.M., O.T.R.), the Research Center of Applied and Preventive Cardiovascular Medicine (J.I., N.K., C.G.M., O.T.R.), and the Departments of Medicine (M.J., J.S.A.V.) and Mathematics and Statistics (N.K.), University of Turku, and the Center for Population Health Research (J.I., N.K., C.G.M., O.T.R.), the Division of Medicine (M.J., J.S.A.V.), and the Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital, Turku, and the Department of Clinical Chemistry, Fimlab Laboratories, and the Finnish Cardiovascular Research Center, and the Faculty of Medicine and Health Technology, Tampere University, Tampere (T.L.) — all in Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS (C.G.M., A.J.V., T.D.), and the Heart Research Group, Murdoch Children’s Research Institute, Melbourne, VIC (T.D.) — both in Australia; the School of Public Health and Tropical Medicine, Tulane University, New Orleans (L.A.B.); the Department of Epidemiology, College of Public Health, University of Iowa, Iowa City (T.L.B.); the Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC (R.J.P.); and the Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom (T.D.)
– sequence: 14
  givenname: Ronald J.
  surname: Prineas
  fullname: Prineas, Ronald J.
  organization: From the Division of Epidemiology and Community Health, School of Public Health (D.R.J.), and the Department of Pediatrics, University of Minnesota Medical School (A.R.S., J.S.), University of Minnesota, Minneapolis; the Division of Biostatistics and Epidemiology (J.G.W., N.Z.), and the Heart Institute (E.M.U.), Cincinnati Children’s Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine (J.G.W., N.Z., E.M.U.) — both in Cincinnati; the Department of Pediatrics, University of Colorado School of Medicine, and Anschutz Medical Campus, Children’s Hospital Colorado — both in Aurora (S.R.D.); the Center for Population Health Research (J.I., N.K., C.G.M., O.T.R.), the Research Center of Applied and Preventive Cardiovascular Medicine (J.I., N.K., C.G.M., O.T.R.), and the Departments of Medicine (M.J., J.S.A.V.) and Mathematics and Statistics (N.K.), University of Turku, and the Center for Population Health Research (J.I., N.K., C.G.M., O.T.R.), the Division of Medicine (M.J., J.S.A.V.), and the Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital, Turku, and the Department of Clinical Chemistry, Fimlab Laboratories, and the Finnish Cardiovascular Research Center, and the Faculty of Medicine and Health Technology, Tampere University, Tampere (T.L.) — all in Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS (C.G.M., A.J.V., T.D.), and the Heart Research Group, Murdoch Children’s Research Institute, Melbourne, VIC (T.D.) — both in Australia; the School of Public Health and Tropical Medicine, Tulane University, New Orleans (L.A.B.); the Department of Epidemiology, College of Public Health, University of Iowa, Iowa City (T.L.B.); the Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC (R.J.P.); and the Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom (T.D.)
– sequence: 15
  givenname: Julia
  surname: Steinberger
  fullname: Steinberger, Julia
  organization: From the Division of Epidemiology and Community Health, School of Public Health (D.R.J.), and the Department of Pediatrics, University of Minnesota Medical School (A.R.S., J.S.), University of Minnesota, Minneapolis; the Division of Biostatistics and Epidemiology (J.G.W., N.Z.), and the Heart Institute (E.M.U.), Cincinnati Children’s Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine (J.G.W., N.Z., E.M.U.) — both in Cincinnati; the Department of Pediatrics, University of Colorado School of Medicine, and Anschutz Medical Campus, Children’s Hospital Colorado — both in Aurora (S.R.D.); the Center for Population Health Research (J.I., N.K., C.G.M., O.T.R.), the Research Center of Applied and Preventive Cardiovascular Medicine (J.I., N.K., C.G.M., O.T.R.), and the Departments of Medicine (M.J., J.S.A.V.) and Mathematics and Statistics (N.K.), University of Turku, and the Center for Population Health Research (J.I., N.K., C.G.M., O.T.R.), the Division of Medicine (M.J., J.S.A.V.), and the Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital, Turku, and the Department of Clinical Chemistry, Fimlab Laboratories, and the Finnish Cardiovascular Research Center, and the Faculty of Medicine and Health Technology, Tampere University, Tampere (T.L.) — all in Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS (C.G.M., A.J.V., T.D.), and the Heart Research Group, Murdoch Children’s Research Institute, Melbourne, VIC (T.D.) — both in Australia; the School of Public Health and Tropical Medicine, Tulane University, New Orleans (L.A.B.); the Department of Epidemiology, College of Public Health, University of Iowa, Iowa City (T.L.B.); the Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC (R.J.P.); and the Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom (T.D.)
– sequence: 16
  givenname: Elaine M.
  surname: Urbina
  fullname: Urbina, Elaine M.
  organization: From the Division of Epidemiology and Community Health, School of Public Health (D.R.J.), and the Department of Pediatrics, University of Minnesota Medical School (A.R.S., J.S.), University of Minnesota, Minneapolis; the Division of Biostatistics and Epidemiology (J.G.W., N.Z.), and the Heart Institute (E.M.U.), Cincinnati Children’s Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine (J.G.W., N.Z., E.M.U.) — both in Cincinnati; the Department of Pediatrics, University of Colorado School of Medicine, and Anschutz Medical Campus, Children’s Hospital Colorado — both in Aurora (S.R.D.); the Center for Population Health Research (J.I., N.K., C.G.M., O.T.R.), the Research Center of Applied and Preventive Cardiovascular Medicine (J.I., N.K., C.G.M., O.T.R.), and the Departments of Medicine (M.J., J.S.A.V.) and Mathematics and Statistics (N.K.), University of Turku, and the Center for Population Health Research (J.I., N.K., C.G.M., O.T.R.), the Division of Medicine (M.J., J.S.A.V.), and the Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital, Turku, and the Department of Clinical Chemistry, Fimlab Laboratories, and the Finnish Cardiovascular Research Center, and the Faculty of Medicine and Health Technology, Tampere University, Tampere (T.L.) — all in Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS (C.G.M., A.J.V., T.D.), and the Heart Research Group, Murdoch Children’s Research Institute, Melbourne, VIC (T.D.) — both in Australia; the School of Public Health and Tropical Medicine, Tulane University, New Orleans (L.A.B.); the Department of Epidemiology, College of Public Health, University of Iowa, Iowa City (T.L.B.); the Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC (R.J.P.); and the Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom (T.D.)
– sequence: 17
  givenname: Alison J.
  surname: Venn
  fullname: Venn, Alison J.
  organization: From the Division of Epidemiology and Community Health, School of Public Health (D.R.J.), and the Department of Pediatrics, University of Minnesota Medical School (A.R.S., J.S.), University of Minnesota, Minneapolis; the Division of Biostatistics and Epidemiology (J.G.W., N.Z.), and the Heart Institute (E.M.U.), Cincinnati Children’s Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine (J.G.W., N.Z., E.M.U.) — both in Cincinnati; the Department of Pediatrics, University of Colorado School of Medicine, and Anschutz Medical Campus, Children’s Hospital Colorado — both in Aurora (S.R.D.); the Center for Population Health Research (J.I., N.K., C.G.M., O.T.R.), the Research Center of Applied and Preventive Cardiovascular Medicine (J.I., N.K., C.G.M., O.T.R.), and the Departments of Medicine (M.J., J.S.A.V.) and Mathematics and Statistics (N.K.), University of Turku, and the Center for Population Health Research (J.I., N.K., C.G.M., O.T.R.), the Division of Medicine (M.J., J.S.A.V.), and the Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital, Turku, and the Department of Clinical Chemistry, Fimlab Laboratories, and the Finnish Cardiovascular Research Center, and the Faculty of Medicine and Health Technology, Tampere University, Tampere (T.L.) — all in Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS (C.G.M., A.J.V., T.D.), and the Heart Research Group, Murdoch Children’s Research Institute, Melbourne, VIC (T.D.) — both in Australia; the School of Public Health and Tropical Medicine, Tulane University, New Orleans (L.A.B.); the Department of Epidemiology, College of Public Health, University of Iowa, Iowa City (T.L.B.); the Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC (R.J.P.); and the Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom (T.D.)
– sequence: 18
  givenname: Olli T.
  surname: Raitakari
  fullname: Raitakari, Olli T.
  organization: From the Division of Epidemiology and Community Health, School of Public Health (D.R.J.), and the Department of Pediatrics, University of Minnesota Medical School (A.R.S., J.S.), University of Minnesota, Minneapolis; the Division of Biostatistics and Epidemiology (J.G.W., N.Z.), and the Heart Institute (E.M.U.), Cincinnati Children’s Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine (J.G.W., N.Z., E.M.U.) — both in Cincinnati; the Department of Pediatrics, University of Colorado School of Medicine, and Anschutz Medical Campus, Children’s Hospital Colorado — both in Aurora (S.R.D.); the Center for Population Health Research (J.I., N.K., C.G.M., O.T.R.), the Research Center of Applied and Preventive Cardiovascular Medicine (J.I., N.K., C.G.M., O.T.R.), and the Departments of Medicine (M.J., J.S.A.V.) and Mathematics and Statistics (N.K.), University of Turku, and the Center for Population Health Research (J.I., N.K., C.G.M., O.T.R.), the Division of Medicine (M.J., J.S.A.V.), and the Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital, Turku, and the Department of Clinical Chemistry, Fimlab Laboratories, and the Finnish Cardiovascular Research Center, and the Faculty of Medicine and Health Technology, Tampere University, Tampere (T.L.) — all in Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS (C.G.M., A.J.V., T.D.), and the Heart Research Group, Murdoch Children’s Research Institute, Melbourne, VIC (T.D.) — both in Australia; the School of Public Health and Tropical Medicine, Tulane University, New Orleans (L.A.B.); the Department of Epidemiology, College of Public Health, University of Iowa, Iowa City (T.L.B.); the Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC (R.J.P.); and the Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom (T.D.)
– sequence: 19
  givenname: Terence
  surname: Dwyer
  fullname: Dwyer, Terence
  organization: From the Division of Epidemiology and Community Health, School of Public Health (D.R.J.), and the Department of Pediatrics, University of Minnesota Medical School (A.R.S., J.S.), University of Minnesota, Minneapolis; the Division of Biostatistics and Epidemiology (J.G.W., N.Z.), and the Heart Institute (E.M.U.), Cincinnati Children’s Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine (J.G.W., N.Z., E.M.U.) — both in Cincinnati; the Department of Pediatrics, University of Colorado School of Medicine, and Anschutz Medical Campus, Children’s Hospital Colorado — both in Aurora (S.R.D.); the Center for Population Health Research (J.I., N.K., C.G.M., O.T.R.), the Research Center of Applied and Preventive Cardiovascular Medicine (J.I., N.K., C.G.M., O.T.R.), and the Departments of Medicine (M.J., J.S.A.V.) and Mathematics and Statistics (N.K.), University of Turku, and the Center for Population Health Research (J.I., N.K., C.G.M., O.T.R.), the Division of Medicine (M.J., J.S.A.V.), and the Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital, Turku, and the Department of Clinical Chemistry, Fimlab Laboratories, and the Finnish Cardiovascular Research Center, and the Faculty of Medicine and Health Technology, Tampere University, Tampere (T.L.) — all in Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS (C.G.M., A.J.V., T.D.), and the Heart Research Group, Murdoch Children’s Research Institute, Melbourne, VIC (T.D.) — both in Australia; the School of Public Health and Tropical Medicine, Tulane University, New Orleans (L.A.B.); the Department of Epidemiology, College of Public Health, University of Iowa, Iowa City (T.L.B.); the Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC (R.J.P.); and the Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom (T.D.)
BackLink https://www.ncbi.nlm.nih.gov/pubmed/35373933$$D View this record in MEDLINE/PubMed
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Drs. Jacobs, Woo, and Sinaiko and Drs. Bazzano, Burns, Prineas, Steinberger, Urbina, Venn, Raitakari, and Dwyer contributed equally to this article.
The authors’ full names, academic degrees, and affiliations are listed in the Appendix.
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Snippet In this study, childhood cardiovascular risk factors including BMI, systolic blood pressure, lipid levels, and smoking were correlated with cardiovascular...
Childhood cardiovascular risk factors predict subclinical adult cardiovascular disease, but links to clinical events are unclear. In a prospective cohort study...
AbstractBackgroundChildhood cardiovascular risk factors predict subclinical adult cardiovascular disease, but links to clinical events are unclear.MethodsIn a...
Childhood cardiovascular risk factors predict subclinical adult cardiovascular disease, but links to clinical events are unclear.BACKGROUNDChildhood...
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StartPage 1877
SubjectTerms Adolescent
Adult
Adults
Age
Blood pressure
Cardiology
Cardiovascular disease
Cardiovascular diseases
Cardiovascular Diseases - epidemiology
Cardiovascular Diseases - etiology
Child
Child development
Child, Preschool
Childhood
Children
Cholesterol
Clinical Medicine
Clinical Medicine General
Consent
Consortia
Female
Heart Disease Risk Factors
Humans
Hypotheses
Male
Medical records
Pediatrics
Pediatrics General
Prevention
Prospective Studies
Public Health
Public Health General
Risk Factors
Smoking
Statistical analysis
Triglycerides
Young Adult
SubjectTermsDisplay Cardiology
Clinical Medicine
Clinical Medicine General
Pediatrics
Pediatrics General
Prevention
Public Health
Public Health General
Title Childhood Cardiovascular Risk Factors and Adult Cardiovascular Events
URI https://nejm.org/doi/full/10.1056/NEJMoa2109191
https://www.ncbi.nlm.nih.gov/pubmed/35373933
https://www.proquest.com/docview/2666554310
https://www.proquest.com/docview/2646937241
https://pubmed.ncbi.nlm.nih.gov/PMC9563825
Volume 386
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