Clustering of risk factors for coronary heart disease: The longitudinal relationship with lifestyle

PURPOSE: The purpose of this study was to investigate whether or not cluste ring of biological coronary heart disease (CHD) risk factors exists and to investigate the longitudinal relationship between lifestyle parameters (die tary intake, daily physical activity, smoking behaviour, alcohol consumptio n) and a biological CHD risk factor clustering score. This was defined as b elonging to one or more gender specific 'high risk' quartiles for the follo wing CHD risk factors: ratio between total serum cholesterol and high densi ty lipoprotein cholesterol (TC:HDL), mean arterial blood pressure (MABP), b ody fatness [sum of skinfolds (SSF)], and cardiopulmonary fitness (VO2-max) . METHODS: The data were derived from the Amsterdam Growth and Health Study, an observational longitudinal study in which six repeated measurements were carried out over a period of 15 years covering adolescence and young adult hood (n = 181). The longitudinal relationships were analysed with generaliz ed estimating equations. RESULTS: The results showed significant clustering for the TC:HDL ratio, SS F, and VO2-max. MABP was not significantly associated with the other CHD ri sk factors. Daily physical activity and alcohol consumption (only for males ) were both inversely related to the clustering score. None of the other li festyle parameters showed significant relationships with the clustering sco re. CONCLUSIONS: Based on this small longitudinal study, it can be stated chat during adolescence and young adulthood both daily physical activity and alc ohol consumption were related to a healthy CHD risk profile. Ann Epidemiol 2001;11:157-165. (C) 2001 Elsevier Science Inc. All rights reserved.