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Editorial
. 2020 Dec 8;76(23):2708-2711.
doi: 10.1016/j.jacc.2020.10.011.

Life Course Developmental Approach to Cardiovascular Health and Cardiovascular Disease Prevention: Opportunities and Unanswered Questions

Ramachandran S Vasan  1 , Justin P Zachariah  2 , Vanessa Xanthakis  3
Affiliations
Editorial

Life Course Developmental Approach to Cardiovascular Health and Cardiovascular Disease Prevention: Opportunities and Unanswered Questions

Ramachandran S Vasan et al. J Am Coll Cardiol. .
No abstract available

Keywords: cardiovascular health; cohort studies; epidemiology; lifecourse; race; risk; social determinant of health.

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Conflict of interest statement

Author Disclosures Dr. Vasan is supported by contracts NO1-HC-25195, HHSN268201500001I and 75N92019D00031, and U01HL146382 from the National Heart, Lung, and Blood Institute; and by the Evans Medical Foundation and the Jay and Louis Coffman Endowment from the Department of Medicine, Boston University School of Medicine. Dr. Zachariah is supported by R01 HL148217 from the National Heart, Lung, and Blood Institute. Dr. Xanthakis has reported that she has no relationships relevant to the contents of this paper to disclose.

Figures

Figure.
Figure.
The evolution of health trajectories under the influence of macro- and micro-level factors. The left side of the Figure reflects the various factors at the individual-, the community- and macrosocial levels (sometime referred to as the exposome) that impact health trajectories over the life course. The right side of the Figure displays how health trajectories evolve based on the interactions of the individual’s genetic and epigenetic background with the ‘exposome’. Such interactions impact health reserve and resilience and may confer allostatic load (bottom of Figure). As a result, a range of health trajectories can manifest ranging from an ideal (green line), an average (blue and purple lines) or a suboptimal (red line) profile over the life course. Average and suboptimal health trajectories are associated with multi-morbidity. The black dots along the lines reflect snapshots in time that are observed in studies, and underscore the importance of serial longitudinal observations. The boxes with italicized terms in the upper part of the Figure reflect select key concepts under the LHD model. The lower part of the Figure illustrates how these factors are important at every life stage and influence health span and lifespan.
See this image and copyright information in PMC

Comment on

References

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