Long-term Excessive Body Weight and Adult Left Ventricular Hypertrophy Are Linked Through Later Life Body Size and Blood Pressure: The Bogalusa Heart Study
Rationale: Childhood adiposity is associated with cardiac structure in later life, but little is known regarding to what extent childhood body weight affects adult left ventricular geometric patterns through adult body size and blood pressure (BP).
Objective: Determine quantitatively the mediation effect of adult body weight and BP on the association of childhood BMI with adult left ventricular hypertrophy (LVH).
Methods and Results: This longitudinal study consisted of 710 adults, age 26 to 48 years, who had been examined for BMI and BP measured 4 or more times during childhood and 2 or more times during adulthood, with a mean follow-up period of 28.0 years. After adjusting for age, race and sex, adult BMI had a significant mediation effect (76.4%, p<0.01) on the childhood BMI-adult LV mass index (LVMI) association. The mediation effects of adult systolic BP (SBP, 15.2%), long-term burden (12.1%) and increasing trends of SBP (7.9%) were all significant (p<0.01). Furthermore, these mediators also had significant mediation effects on the association of childhood BMI with adult LVH, eccentric and concentric hypertrophy. Importantly, the mediation effects of adult BMI were all significantly stronger than those of adult SBP on LVMI, LVH and LV remodeling patterns (p<0.01). Additionally, the mediation effect of SBP on concentric hypertrophy was significantly stronger than on eccentric hypertrophy (p<0.01).
Conclusions: These findings suggest that increased childhood BMI has long-term adverse impact on subclinical changes in adult cardiac structure, and early life excessive body weight and adult LVH are linked through later life excessive body weight and elevated BP.
- Received December 3, 2016.
- Revision received February 10, 2017.
- Accepted February 16, 2017.