Cohort Profile: The Cardiovascular Risk in Young Finns Study

Raitakari, Olli T.; Juonala, Markus; Rönnemaa, Tapani; Keltikangas‐Järvinen, Liisa; Rásänen, Leena; Pietikäinen, M; Hutri‐Kähönen, Nina; Taittonen, Leena; Jokinen, Eero; Marniemi, Jukka; Jula, Antti; Telama, R.; Kähönen, Mika; Lehtimäki, Terho; Åkerblom, Hans K.; Viikari, Jorma

doi:10.1093/ije/dym225

Cited by 653 publications

(661 citation statements)

References 42 publications

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“…The first cross-sectional study was conducted in 1980 for 3596 subjects aged 3 to 18 years. 20 They were randomly selected from the Finnish national population register. Although data were available for participants aged 3 years in 1980 (n = 577), they were not included in the analyses because BP measures were collected using an ultrasound device.…”

Section: Subjectsmentioning

confidence: 99%

Simplified Definitions of Elevated Pediatric Blood Pressure and High Adult Arterial Stiffness

et al. 2013

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WHAT'S KNOWN ON THIS SUBJECT: Elevated blood pressure (BP) has long-term influence on the atherosclerotic process. The relative predictive ability of the standard BP definition endorsed by the National High Blood Pressure Education Program and the recently proposed 2 simplified definitions has not been studied. WHAT THIS STUDY ADDS:Simplified pediatric BP tables predict risk of high adult arterial stiffness as well as the complex table does. These simple screening tools could be used for identifying pediatric subjects at risk and for intervening to improve adult cardiovascular outcomes.abstract OBJECTIVE: The ability of childhood elevated blood pressure (BP) to predict high pulse wave velocity (PWV), a surrogate marker for cardiovascular disease, in adulthood has not been reported. We studied whether elevated pediatric BP could predict high PWV in adulthood and if there is a difference in the predictive ability between the standard BP definition endorsed by the National High Blood Pressure Education Program and the recently proposed 2 simplified definitions. METHODS:The sample comprised 1241 subjects from the Cardiovascular Risk in Young Finns Study followed-up 27 years since baseline (1980, aged 6-15 years). Arterial PWV was measured in 2007 by whole-body impedance cardiography. RESULTS:The relative risk for high PWV was 1.5 using the simple 1 (age-specific) definition, 1.6 using the simple 2 (age-and genderspecific) definition, and 1.7 using the complex (age-, gender-, and height-specific) definition (95% confidence interval: 1.1-2.0, P = .007; 1.2-2.2, P = .001; and 1.2-2.2, P = .001, respectively). Predictions of high PWV were equivalent for the simple 1 or simple 2 versus complex definition (P = .25 and P = .68 for area under the curve comparisons, P = .13 and P = .35 for net reclassification indexes, respectively). CONCLUSIONS:Our results support the previous finding that elevated BP tracks from childhood to adulthood and accelerates the atherosclerotic process. The simplified BP tables could be used to identify pediatric patients at increased risk of high arterial stiffness in adulthood and hence to improve the primary prevention of cardiovascular diseases. Pediatrics 2013;132:e70-e76

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Section: Subjectsmentioning

confidence: 99%

Simplified Definitions of Elevated Pediatric Blood Pressure and High Adult Arterial Stiffness

et al. 2013

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“…This is an ongoing, prospective, five-center follow-up study of atherosclerosis risk factors in Finnish children and adolescents. The participants were randomly chosen from a national population register as described previously (18). At the beginning of the study in 1980, there were 3596 participants.…”

Section: Subjectsmentioning

confidence: 99%

“…The menstrual cycle phase at the sampling time and the use of OCs were obtained from the participants. The menstrual cycle was divided into four different phases: early follicular phase (1-7 days from the beginning of menstruation), late follicular phase (8-14 days from the beginning of menstruation), early luteal phase (15)(16)(17)(18)(19) days from the beginning of menstruation), and late luteal phase (20-40 days from the beginning of menstruation). Contraceptive types were divided into four categories: constant estrogen dose with low progestin dose (nZ110), constant estrogen dose with high progestin dose (nZ120), progestin alone (nZ10), and combination preparation with changing doses (nZ68).…”

Section: Subjectsmentioning

confidence: 99%

ADMA concentration changes across the menstrual cycle and during oral contraceptive use: the Cardiovascular Risk in Young Finns Study

Valtonen

Punnonen²,

Saarelainen³

et al. 2010

European Journal of Endocrinology

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Objective: The aim of this study was to evaluate changes in the nitric oxide synthase inhibitor asymmetric dimethylarginine (ADMA) levels during different menstrual cycle phases in young adult women with or without oral contraceptive (OC) use. Design and methods: The subjects (nZ1079) originated from a large population-based, prospective cohort study conducted in Finland. Plasma ADMA, symmetric dimethylarginine (SDMA), L-arginine, C-reactive protein, creatinine, and brachial artery flow-mediated dilatation (FMD) were measured. The use of OCs and menstrual cycle phase were determined from a questionnaire. Results: In non-OC users, ADMA (PZ0.017), L-arginine (PZ0.002), and ADMA/SDMA ratio (P!0.001) were significantly lower in the luteal phase than in the follicular phase of the menstrual cycle. Non-OC users also had significantly higher ADMA and SDMA concentrations (P!0.001) and lower L-arginine concentrations (P!0.001) compared to OC users of estrogen-containing pills. Progestin-only contraceptive pills (POPs) did not lower the ADMA level, but maintained it at the same level as in non-OC users. In OC users, there were no significant differences found in ADMA, FMD, or FMD% across menstrual cycle, whereas brachial artery diameter was significantly more decreased in the luteal phase (PZ0.013) than in the follicular phase. Conclusion: We observed that the circulating ADMA concentration varies across the menstrual cycle in young women not using OCs, and women on OCs displayed significantly lower circulating ADMA concentrations than non-OC users, though this was not the case with POP contraception.

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“…The age-standardized prevalence of obesity (defined as a BMI $95th percentile for age and sex) in youth (12)(13)(14)(15)(16)(17)(18)(19) years of age) between 1976-1980 and 2009-2010 has increased from 5.3 to 17.1% in girls and from 4.8 to 19.6% among boys in the U.S. (1,2). Youth and early adulthood overweight have been found to predict the development of type 2 diabetes mellitus (T2DM) and cardiovascular disease later in life (4)(5)(6)(7).…”

mentioning

confidence: 99%

Youth Overweight and Metabolic Disturbances in Predicting Carotid Intima-Media Thickness, Type 2 Diabetes, and Metabolic Syndrome in Adulthood: The Cardiovascular Risk in Young Finns Study

et al. 2014

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OBJECTIVEOur objective was to assess cardiovascular risk and metabolic complications in adulthood in subjects with or without overweight and metabolic disturbances (i.e., elevated blood pressure, glucose, triglycerides, low HDL cholesterol, and high LDL cholesterol) and their combinations as youth. RESEARCH DESIGN AND METHODSUsing data from the population-based Cardiovascular Risk in Young Finns study, we examined the utility of four age-and sex-specific youth phenotypes (group I: normal weight, no metabolic disturbances; group II: normal weight, one or more metabolic disturbances; group III: overweight/obese, no metabolic disturbances; group IV: overweight/obese, one or more metabolic disturbances) in predicting adult high carotid intima-media thickness (IMT), type 2 diabetes mellitus (T2DM), and metabolic syndrome (MetS). The study included 1,617 participants 9-24 years of age at baseline who were followed up 21-25 years later. RESULTSIMT (mean 6 SEM) was higher among participants in groups II (0.627 6 0.005 mm, P = 0.05), III (0.647 6 0.010 mm, P = 0.005), and IV (0.670 6 0.010 mm, P < 0.0001) compared with group I (0.616 6 0.003 mm). In addition, subjects in group IV had significantly higher IMT compared with those in group II (P = 0.002). Participants in groups II, III, and IV were at increased risk of the development of MetS in adulthood compared with those in the control group. For group II participants, the difference was attenuated after risk factor adjustments. Additionally, participants in group III and IV were at increased risk of the development of T2DM compared with those in groups I and II. CONCLUSIONSWhile metabolic risk factors associated with overweight increase future risk for MetS, T2DM, and increased IMT, overweight in isolation is also a risk factor. Therefore, overweight should be prevented and treated wherever possible.

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Cohort Profile: The Cardiovascular Risk in Young Finns Study

Cited by 653 publications

References 42 publications

Simplified Definitions of Elevated Pediatric Blood Pressure and High Adult Arterial Stiffness

Simplified Definitions of Elevated Pediatric Blood Pressure and High Adult Arterial Stiffness

ADMA concentration changes across the menstrual cycle and during oral contraceptive use: the Cardiovascular Risk in Young Finns Study

Youth Overweight and Metabolic Disturbances in Predicting Carotid Intima-Media Thickness, Type 2 Diabetes, and Metabolic Syndrome in Adulthood: The Cardiovascular Risk in Young Finns Study

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