• Annals of medicine · Dec 2021

    Influence of early-lifebody mass index and systolic blood pressure on left ventricle in adulthood - The Cardiovascular Risk in Young Finns Study.

    • Jarkko S Heiskanen, Jussi A Hernesniemi, Saku Ruohonen, Nina Hutri-Kähönen, Mika Kähönen, Eero Jokinen, Päivi Tossavainen, Merja Kallio, Tomi Laitinen, Terho Lehtimäki, Jorma Viikari, Markus Juonala, Jaakko Nevalainen, and Olli T Raitakari.
    • Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
    • Ann. Med. 2021 Dec 1; 53 (1): 160-168.

    BackgroundIncreased left ventricular mass (LVM) predicts cardiovascular events and mortality. The objective of this study was to determine whether early-life exposures to body mass index (BMI) and systolic blood pressure (SPB) affects the left ventricular structure in adulthood.MethodsWe used longitudinal data from a 31-year follow-up to examine the associations between early-life (between ages 6-18) BMI and SPB on LVM in an adult population (N = 1864, aged 34-49). The burden of early-life BMI and SBP was defined as area under the curve.ResultsAfter accounting for contemporary adult determinants of LVM, early-life BMI burden associated significantly with LVM (3.61 g/SD increase in early-life BMI; [1.94 - 5.28], p < 0.001). Overweight in early-life (age- and sex-specific BMI values corresponding to adult BMI > 25 kg/m2) associated with 4.7% (2.5-6.9%, p < 0.0001) higher LVM regardless of BMI status in adulthood. Overweight in early-life combined with obesity in adulthood (BMI > 30kg/m2) resulted in a 21% (17.3-32.9%, p < 0.0001) increase in LVM. Higher early-life BMI was associated with a risk of developing eccentric hypertrophy. The burden of early-life SPB was not associated with adult LVM or left ventricular remodeling.ConclusionsHigh BMI in early-life confers a sustained effect on LVM and the risk for eccentric hypertrophy independently of adulthood risk factors. KEY MESSAGES Excess in BMI in early-life has an independent effect on LVM and the risk of developing eccentric hypertrophy regardless of overweight status in adulthood. Systolic blood pressure levels in early-life did not have an independent effect on LVM or LV remodeling. The clinical implication of this study is that primary prevention of obesity in early-life may prevent the development of high LVM and eccentric hypertrophy.

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