LONGITUDINAL CHANGES IN CARDIOVASCULAR RISK FROM CHILDHOOD TO YOUNG ADULTHOOD IN OFFSPRING OF PARENTS WITH CORONARY-ARTERY DISEASE - THE BOGALUSA HEART-STUDY

Context.-Although the association between parental coronary artery dis ease (CAD) and its risk factors in the offspring is known, the timing and the course of development of risk factors from childhood to adulth ood in the offspring is not known. Objective.-To examine the associati on between parental CAD and longitudinal changes in risk factor profil e from childhood to young adulthood in offspring. Design.-Cohort study . Setting.-Bogalusa, La, a semirural, biracial community. Participants .-Individuals with clinically verified parental history of CAD (n = 27 1) vs those without such a history (n=1253) Mean age at first CAD even t was 50 years for fathers and 52 years for mothers. Main Outcome Meas ures.-Body mass index, subscapular skinfolds, blood pressure, and trig lyceride, cholesterol (total, very low-density lipoprotein [VLDL-C], l ow-density lipoprotein [LDL-C], and high-density lipoprotein [HDL-C] c holesterols), glucose, and insulin levels. Results.-The offspring of p arents with CAD were consistently overweight beginning in childhood. T heir levels of total serum cholesterol, LDL-C, plasma glucose, and ins ulin became significantly higher at older ages, because of a higher ra te of increase in these risk factors over time. In adulthood, the offs pring with a positive parental history had a higher prevalence of obes ity (body mass index >85th percentile in the National Health and Nutri tion Examination Survey I, 35% vs 26%, P=.01), elevated total choleste rol (>6.2 mmol/L [240 mg/dL], 8.4% vs 4.8%, P=.05) and LDL-C levels (> 4.1 mmol/L [160 mg/dL], 12.4% vs 4.7%, P=.05), and hyperglycemia (gluc ose, >6.6 mmol/L, 2.7% vs 0.4%, P<.001), as well as a higher coexisten ce of these conditions (P=.01). Further, the prevalence of dyslipidemi a, either involving only LDL-C or LDL-C in combination with HDL-C or t riglycerides or both, was significantly higher in the adult offspring with parental CAD. Conclusions.-Offspring of parents with early CAD we re overweight beginning in childhood and developed an adverse cardiova scular risk factor profile ai an increased rate. These observations ha ve important implications for prevention and intervention.