Childhood risk factors have a significant impact on adult cardiovascular disease (CVD), both directly and indirectly, according to a new study published on June 24 in JAMA Network Open.

The research, led by Noora Kartiosuo from the University of Turku, analyzed the effects of childhood risk factors on adult CVD over a median follow-up period of 23.6 years, involving 10,634 participants. The study aimed to quantify the relative importance of these risk factors at different stages of life.

Key findings indicate that childhood levels of low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglycerides, systolic blood pressure (SBP), smoking, and body mass index (BMI) are all associated with adult CVD. Childhood BMI and LDL-C were found to have direct effects on adult CVD, with an incidence rate ratio (RR) per one standard deviation (SD) unit of 1.18 for BMI and 1.16 for LDL-C.

Indirect effects were more pronounced for total cholesterol, triglycerides, systolic blood pressure, and a combined score of these risk factors. Notably, the impact of childhood smoking on CVD was mediated entirely through smoking in adulthood. The study highlighted that childhood BMI is nearly as influential on the risk of adult CVD as adult BMI, whereas other childhood risk factors and the combined score indicated that adulthood is a more critical period for intervention.

The authors concluded that early intervention targeting childhood risk factors, particularly BMI, is essential to reduce the incidence of adult cardiovascular disease. "These findings suggest that intervention for childhood risk factors, in particular BMI, is warranted to reduce incidence of adult CVD as it cannot be fully mitigated by risk factor management in adulthood," they wrote.

It is important to note that two authors of the study disclosed connections to the pharmaceutical industry, although the nature of these ties was not specified in the publication.