CARDIOVASCULAR RISK-FACTORS IN BRITISH CHILDREN FROM TOWNS WITH WIDELY DIFFERING ADULT CARDIOVASCULAR MORTALITY

Objective-To examine whether cardiovascular risk factors differ in chi ldren from towns in England and Wales with widely differing adult card iovascular death rates. Design-School based survey conducted during 19 94 in 10 towns, five with exceptionally high adult cardiovascular mort ality (standardised mortality ratio 131-143) and five with exceptional ly low adult cardiovascular mortality (64-75). Towns were surveyed in high-low pairs. Subjects-3415 white children aged 8-11 years with phys ical measurements (response rate 75%), including 1287 with blood sampl es (response rate 64%), of whom 515 had blood samples taken 30 minutes after a glucose load. Results-Children in towns with high cardiovascu lar mortality were on average shorter than those in towns with low mor tality (mean difference 1.2 cm; 95% confidence interval 0.3 to 2.1 cm; P = 0.02) and had a higher ponderal index (0.34 kg/m(3); 0.16 to 0.52 kg/m(3); P = 0.006). Mean systolic pressure was higher in high mortal ity towns, particularly after adjustment for height (2.0 mm Hg; 0.8 to 3.2 mm Hg; P = 0.009). Mean waist:hip ratio, total cholesterol concen tration, and 30 minute post-load glucose measurements were similar in high and low mortality towns. The differences in height and blood pres sure between high and low mortality towns were unaffected by standardi sation for birth weight. Conclusions-The differences in height, ponder al index, and blood pressure between towns with high and low cardiovas cular mortality, if persistent, may have important future public healt h implications. Their independence of birth weight suggests that the c hildhood environment rather than the intrauterine environment is invol ved in their development.