Sociodemographic Correlates of High Cardiovascular Health Across Childhood and Adolescence: A Prospective Study Among 2 Cohorts in the ECHO Consortium.
Wei Perng, Noya Galai, Qi Zhao, Augusto Litonjua, Sarah Geiger, Katherine A Sauder, T Michael O'Shea, Marie-France Hivert, Emily Oken, Dana Dabelea, Izzuddin M Aris, ECHO Cohort Consortium
Author Information
Wei Perng: Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center University of Colorado Anschutz Medical Campus Aurora CO. ORCID
Noya Galai: Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MD. ORCID
Qi Zhao: Department of Preventive Medicine College of Medicine University of Tennessee Health Science Center Memphis TN. ORCID
Augusto Litonjua: Department of Pediatrics University of Rochester Medical Center Rochester NY. ORCID
Sarah Geiger: Department of Kinesiology and Community Health College of Applied Health Sciences University of Illinois at Urbana-Champaign Champaign IL.
Katherine A Sauder: Department of Implementation Science Wake Forest University School of Medicine Winston-Salem NC.
T Michael O'Shea: Department of Pediatrics University of North Carolina School of Medicine Chapel Hill NC. ORCID
Marie-France Hivert: Division of Chronic Disease Research Across the Lifecourse Department of Population Medicine Harvard Medical School and Harvard Pilgrim Health Care Institute Boston MA. ORCID
Emily Oken: Division of Chronic Disease Research Across the Lifecourse Department of Population Medicine Harvard Medical School and Harvard Pilgrim Health Care Institute Boston MA. ORCID
Dana Dabelea: Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center University of Colorado Anschutz Medical Campus Aurora CO. ORCID
Izzuddin M Aris: Division of Chronic Disease Research Across the Lifecourse Department of Population Medicine Harvard Medical School and Harvard Pilgrim Health Care Institute Boston MA. ORCID
BACKGROUND: This study seeks to characterize cardiovascular health (CVH) from early childhood to late adolescence and identify sociodemographic correlates of high CVH that serve as levers for optimizing CVH across early life. METHODS AND RESULTS: Among 1530 youth aged 3 to 20 years from 2 cohorts in the ECHO (Environmental Influences on Child Health Outcomes) consortium, we first derived CVH scores on the basis of the Life's Essential 8 construct comprising 4 behavioral (nicotine use/exposure, physical activity, sleep, and diet) and 4 health factors (body mass index, blood pressure, non-high-density lipoprotein cholesterol, and fasting glucose) during early childhood (mean age, 3.5 years), middle childhood (8.0 years), early adolescence (13.3 years), and late adolescence (17.8 years). Next, we used generalized regression to estimate the probability of high (versus not high) CVH with respect to sociodemographic characteristics. Overall CVH score was stable across life stages: 81.2±7.6, 83.3±8.0, and 81.7±8.9 of 100 possible points in early childhood, middle childhood, and early adolescence, respectively. Accordingly, during these life stages, most children (63.3%-71.5%) had high CVH (80 to <100). However, CVH declined by late adolescence, with an average score of 75.5±10.2 and 39.4% high CVH. No children had optimal CVH (score=100) at any time. Correlates of high CVH include non-Hispanic White race and ethnicity, maternal college education, and annual household income >$70 000. These associations were driven by behavioral factors. CONCLUSIONS: Although most youth maintained high CVH across childhood, the decline by late adolescence indicates that cardiovascular disease prevention should occur before the early teen years. Disparities in high CVH over time with respect to sociodemographic characteristics were explained by behavioral factors, pointing toward prevention targets.
