The emergence of clinically abnormal levels of cardiovascular disease risk factor variables among young adults: the Bogalusa Heart Study

Abstract

Background: The Bogalusa Heart Study, a long-term epidemiologic investigation of the early natural history of atherosclerosis, was conducted for the first time in 1973-1974 on children from birth through the age of 14 in a biracial (black-white) population.

Methods: The emergence of clinically recognizable abnormalities (obesity, hypertension, and hyperlipidemia) was studied in 1,928 young adults, ages 19-32 years, examined in the 1988-1991 survey.

Results: The occurrence of morbid levels of cardiovascular disease risk factors varied by race and gender. The prevalence of severe overweight, body mass index > or = 31.1 kg/m2 for males and > or = 32.3 kg/m2 for females, was much higher for black women (20.1% than for white women (8.7%), black men (14.0%), or white men (11.7%). The frequency of hypertension [systolic blood pressure (BP) > or = 140 mm Hg, diastolic BP > or = 90 mm Hg, or treatment for high BP] was greatest for black women (13.9%) versus black men (10.1%), white men (6.2%), or white women (5.0%). Approximately 9.5% of the men and 6% of the women had elevated LDL cholesterol ( > or = 160 mg/dl), while elevated triglycerides ( > or = 250 mg/dl ranged from 0% in black females to 7.4% in white males. Dyslipoproteinemia related to HDL cholesterol ( < or = 35 mg/dl) was more marked among white men (16%) compared with other groups (approximately 4%). Correlations for risk factors in a subgroup of 1,587 individuals initially surveyed as children in 1973-1974 were examined as an indication of tracking over a 15-year period. Highly significant correlations were seen for obesity, blood pressure, and LDL cholesterol.

Conclusion: Early identification of adverse levels of cardiovascular disease risk factors defined by clinical experience should help to predict and prevent future cardiovascular disease morbidity and mortality.