A recent study has revealed important insights into cardiovascular health (CVH) during the early years of life, which may explain some of the disparities in CVH seen later in adulthood. It appears that CVH scores start to decline around the age of 10 across different demographic groups, largely influenced by health behaviors rather than medical factors. To enhance early-life CVH, it’s vital to promote better sleep, a healthier diet, and reduced smoking rates.
Cardiovascular disease (CVD) is a significant public health issue, with risk factors such as elevated blood pressure, abnormal blood sugar, high cholesterol, and obesity emerging in childhood. A new study has identified the pivotal age when cardiovascular health (CVH) begins to deteriorate, highlighting a vital opportunity for targeted interventions aimed at improving CVH as children progress into their teen years and adulthood.
The results of the study were published on December 17 in JAMA Cardiology.
The American Heart Association’s newly established Life’s Essential 8 guidelines evaluate cardiovascular health using four lifestyle (diet, smoking, physical activity, sleep duration) factors and four health metrics (body mass index, blood pressure, blood sugar, and cholesterol levels). Despite the potential of these guidelines to improve CVH assessments across different stages of life, the cardiovascular health status of children in the U.S. remains concerning: only 2% of children aged 2-19 achieve optimal CVH scores, and less than one-third score high (80-100 points).
“We know that good heart health in childhood correlates with lower chances of heart problems later in life, yet the current cardiovascular health situation for U.S. children is troubling,” said Izzuddin Aris, the lead author and assistant professor of population medicine at Harvard Medical School, affiliated with the Harvard Pilgrim Health Care Institute. “Our study sheds light on the trajectory of cardiovascular health during early life, providing a clear opportunity to enhance the well-being of children across the nation now and in the future.”
The research team, using the Life’s Essential 8 framework, analyzed data from over 1,500 children involved in the Project Viva pre-birth cohort in eastern Massachusetts. To be included in the study, participants needed data on at least three CVH metrics in early childhood or four metrics in mid-childhood, early adolescence, or late adolescence. The team evaluated six CVH metrics in early childhood (diet, smoking, physical activity, sleep duration, BMI, and BP), and up to eight from mid-childhood to late adolescence.
The study found that CVH scores begin to drop around age 10 across all demographic groups, influenced more by health behaviors than by health factors. This downward trend may reflect social and developmental shifts common at this stage, such as changes in school routines that can interfere with obtaining adequate sleep and maintaining a healthy diet, thereby affecting overall health behaviors. By improving these behaviors, particularly during the transition from mid-childhood to early adolescence, it may be possible to enhance CVH.
Additionally, the authors noted small yet significant differences in CVH trajectories related to the socioeconomic status of mothers and the race and ethnicity of children.
“Our findings emphasize the early impact of structural factors associated with socioeconomic status and race and ethnicity—such as living in favorable neighborhoods, having access to nutritious food, and being close to safe areas that promote physical activity—that might contribute to future cardiovascular health disparities,” Dr. Aris stated. “By identifying the most vulnerable age for CVH decline, we can better target preventive measures toward high-risk children and deepen our understanding of the early life factors that lead to CVH deterioration.”
