Am J Prev Med. 2023 Sep 24:S0749-3797(23)00382-3. doi: 10.1016/j.amepre.2023.09.019. Online ahead of print.

ABSTRACT

INTRODUCTION: Clinical cardiovascular health (CVH) is a construct that includes four health factors – systolic and diastolic blood pressure (BP), fasting glucose, total cholesterol, and body mass index [BMI] – which together provide an evidence-based, more holistic view of CVH risk in adults than each component separately. Currently, no pediatric version of this construct exists. This study sought to develop sex-specific charts of clinical CVH-for-age to describe current patterns of clinical CVH throughout childhood.

METHODS: Data were used from children and adolescents ages 8-19 years in six pooled childhood cohorts (19,261 participants, collected between 1972-2010) to create reference standards for fasting glucose and total cholesterol. Using the models for glucose and cholesterol, as well as previously published reference standards for BMI and BP, “Clinical CVH Charts” were developed. All models were estimated using sex-specific random-effects linear regression, and modeling was performed during 2020-2022.

RESULTS: Models were created to generate charts with smoothed means, percentiles, and SDs of clinical CVH for each year of childhood. For example, a 10-year-old girl with a BMI 16 kg/m2 (30th percentile), BP 100/60 mmHg (46th/50th), glucose 80 mg/dL (31st), and total cholesterol 160 mg/dL (46th) (lower implies better) would have a clinical CVH percentile of 62 (higher implies better).

CONCLUSIONS: Clinical CVH Charts based on pediatric data offer a standardized approach to express clinical CVH as an age- and sex-standardized percentile, for clinicians to assess CVH in childhood to consider preventive approaches at early ages and proactively optimize lifetime trajectories of CVH.

PMID:37751803 | DOI:10.1016/j.amepre.2023.09.019