Sex and race (black-white) differences in the relationship of childhood risk factors to adulthood arterial stiffness: the Bogalusa Heart Study

Abstract

Background: Cardiovascular risk factors in childhood are predictive of adulthood arterial stiffness. However, it is unknown whether this relationship varies by race or sex.

Methods: Six hundred and eighty adults aged 24 to 43 had been followed for an average of 26.3 years, from the Bogalusa Heart Study. Brachial to ankle pulse wave velocity (baPWV) measured by an automatic oscillometric technique was used as the outcome variable for arterial stiffness during adulthood. Body mass index (BMI), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), glucose, and systolic blood pressure (SBP), all measured in childhood, were used as predictors. The average values of childhood measurements at multiple time points were used, standardized to age, race, and sex-specific z-scores.

Results: In the total sample, childhood SBP was the only significant predictor (P < 0.001) for adult baPWV. Significant interactions between sex and BMI (P = 0.001), between sex and LDL-C (P = 0.035), and between race and HDL-C (P = 0.002) on adult baPWV were identified. Childhood predictors of adult baPWV were BMI (30.9 cm/s reduction in baPWV per standard deviation increase, 95% confidence interval [CI]: -55.0, -6.9 cm/s), LDL-C (30.8 cm/s increase, 95% CI: 2.9, 59.5 cm/s), and HDL-C (46.8 cm/s reduction, 95% CI: -76.2, -17.4 cm/s) in white males; SBP (38.2 cm/s increase, 95% CI: 11.0, 65.4 cm/s) in white females; BMI (71.3 cm/s reduction, 95% CI: -119.9, -22.7 cm/s) in black males; and none in black females.

Conclusions: The associations of childhood cardiovascular risk factors with adult arterial stiffness varied by race and sex.

Figure 1

Associations of Adult Brachial-Ankle Pulse Wave Velocity with Childhood BMI, Low-Density Lipoprotein (LDL) Cholesterol, and High-Density Lipoprotein (HDL) Cholesterol by Race and/or Sex: The Bogalusa Heart Study WM: white male; WF: white female; BM: black male; BF: black female P values were derived from a single general linear model that included adulthood age, cigarette smoking, heart rate, childhood risk factor variables, race, sex, and the interaction terms between childhood risk factor variables and race/sex. Means of age-, sex-, race-, and survey-standardized z-scores from multiple measurements during childhood were used as childhood values in the general linear model Error bars show one standard error.