Markus Juonala1, Laura Pulkki-Råback2, Marko Elovainio3, Christian Hakulinen4, Costan G Magnussen5, Matthew A Sabin6, David P Burgner7, David L Hare8, Olli Hartiala9, Heikki Ukkonen10, Antti Saraste11, Sami Kajander12, Nina Hutri-Kähönen13, Mika Kähönen14, Irina Rinta-Kiikka15, Tomi Laitinen16, Sakari Kainulainen17, Jorma S A Viikari18, Olli T Raitakari19. 1. Department of Medicine, University of Turku, Turku, Finland2Division of Medicine, Turku University Hospital, Turku, Finland3Murdoch Childrens Research Institute and Royal Children's Hospital, Melbourne, Australia. 2. Helsinki Collegium for Advanced Studies, University of Helsinki, Helsinki, Finland5Unit of Personality, Work and Health, Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland6Helsinki Collegium for Advanced Studies, University of He. 3. Unit of Personality, Work and Health, Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland7National Institute for Health and Welfare, Helsinki, Finland. 4. Unit of Personality, Work and Health, Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland. 5. The Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland9Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia. 6. Murdoch Childrens Research Institute and Royal Children's Hospital, Melbourne, Australia10Department of Pediatrics, University of Melbourne, Melbourne, Australia. 7. Murdoch Childrens Research Institute and Royal Children's Hospital, Melbourne, Australia10Department of Pediatrics, University of Melbourne, Melbourne, Australia11Monash University, Melbourne, Australia. 8. Department of Medicine and Cardiology, University of Melbourne, Melbourne, Australia. 9. The Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland. 10. The Institute of Clinical Medicine, University of Turku, Turku, Finland. 11. Heart Center, Turku University Hospital, Turku, Finland13The Institute of Clinical Medicine, University of Turku, Turku, Finland. 12. Division of Imaging, Turku University Hospital, Turku, Finland. 13. Department of Pediatrics, University of Tampere, Tampere University Hospital, Tampere, Finland. 14. Department of Clinical Physiology, University of Tampere, Tampere University Hospital, Tampere, Finland. 15. Department of Radiology, University of Tampere, Tampere University Hospital, Tampere, Finland. 16. Department of Clinical Physiology, University of Eastern Finland, Kuopio University Hospital, Kuopio, Finland. 17. Department of Radiology, University of Eastern Finland, Kuopio and University Hospital, Kuopio, Finland. 18. Department of Medicine, University of Turku, Turku, Finland2Division of Medicine, Turku University Hospital, Turku, Finland. 19. The Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland21Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland.
Abstract
IMPORTANCE: There is increasing evidence supporting the importance of psychosocial factors in the pathophysiology of atherosclerotic disease. They have been shown to be associated with the population attributable risk for myocardial infarction. OBJECTIVE: To determine if a score of favorable childhood psychosocial factors would be associated with decreased coronary artery calcification in adulthood. DESIGN, SETTING, AND PARTICIPANTS: The analyses were performed in 2015 using data gathered in 1980 and 2008 within the longitudinal Cardiovascular Risk in Young Finns Study. The data source consisted of 311 individuals who had psychosocial factors measured at ages 12 years to 18 years and coronary artery calcification measured 28 years later in adulthood. The summary measure of psychosocial factors in childhood comprised measures of socioeconomic factors, emotional factors, parental health behaviors, stressful events, self-regulation of the child, and social adjustment of the child. MAIN OUTCOMES AND MEASURES: Coronary artery calcification at ages 40 years to 46 years. RESULTS: Of the 311 participants, 48.2% were men. Of the participants, 55 (17.7%) had some calcium observed in their coronary arteries. A 1-SD increase in a favorable summary score of childhood psychological factors was associated with an adulthood coronary artery calcification probability of 0.85 (95% CI, 0.76-0.95) (P = .006). This inverse relationship remained significant after adjustment for age, sex, and conventional childhood risk factors (0.85; 95% CI, 0.74-0.97; P = .02) or for age, sex, adulthood conventional cardiovascular risk factors, socioeconomic status, social support, and depressive symptoms (0.83; 95% CI, 0.71-0.97; P = .02). CONCLUSIONS AND RELEVANCE: In this longitudinal study, we observed an independent association between childhood psychosocial well-being and reduced coronary artery calcification in adulthood. A positive childhood psychosocial environment may decrease cardiovascular risk in adulthood and may represent a potentially modifiable risk determinant.
IMPORTANCE: There is increasing evidence supporting the importance of psychosocial factors in the pathophysiology of atherosclerotic disease. They have been shown to be associated with the population attributable risk for myocardial infarction. OBJECTIVE: To determine if a score of favorable childhood psychosocial factors would be associated with decreased coronary artery calcification in adulthood. DESIGN, SETTING, AND PARTICIPANTS: The analyses were performed in 2015 using data gathered in 1980 and 2008 within the longitudinal Cardiovascular Risk in Young Finns Study. The data source consisted of 311 individuals who had psychosocial factors measured at ages 12 years to 18 years and coronary artery calcification measured 28 years later in adulthood. The summary measure of psychosocial factors in childhood comprised measures of socioeconomic factors, emotional factors, parental health behaviors, stressful events, self-regulation of the child, and social adjustment of the child. MAIN OUTCOMES AND MEASURES: Coronary artery calcification at ages 40 years to 46 years. RESULTS: Of the 311 participants, 48.2% were men. Of the participants, 55 (17.7%) had some calcium observed in their coronary arteries. A 1-SD increase in a favorable summary score of childhood psychological factors was associated with an adulthood coronary artery calcification probability of 0.85 (95% CI, 0.76-0.95) (P = .006). This inverse relationship remained significant after adjustment for age, sex, and conventional childhood risk factors (0.85; 95% CI, 0.74-0.97; P = .02) or for age, sex, adulthood conventional cardiovascular risk factors, socioeconomic status, social support, and depressive symptoms (0.83; 95% CI, 0.71-0.97; P = .02). CONCLUSIONS AND RELEVANCE: In this longitudinal study, we observed an independent association between childhood psychosocial well-being and reduced coronary artery calcification in adulthood. A positive childhood psychosocial environment may decrease cardiovascular risk in adulthood and may represent a potentially modifiable risk determinant.
Authors: Terrance J Wade; Deborah D O'Leary; Kylie S Dempster; Adam J MacNeil; Danielle S Molnar; Jennifer McGrath; John Cairney Journal: BMJ Open Date: 2019-07-16 Impact factor: 2.692