Moderated Poster Australian and New Zealand Stroke Organisation Conference 2025

The association of behavioural cardiovascular health trajectories from childhood to adulthood with stroke indicators in mid-adulthood: findings from a 34-year longitudinal study   (123167)

Moges A Assemie 1 , Seana Gall 1 , Verity Cleland 1 , Alison Venn 1 , Terence Dwyer 2 3 , Jing Tian 1
  1. Menzies Institute for Medical Research, University of Tasmania, Hobart, Tas , Australia
  2. Murdoch Children’s Research Institute, The Royal Children’s Hospital, Parkville, Victoria , Australia
  3. Department of Paediatrics, The University of Melbourne, Melbourne Medical School, Parkville, Victoria , Australia

Aim: To examine associations between behavioural cardiovascular health (CVH) trajectories from childhood to adulthood and stroke markers in mid-adulthood.

Method: A score comprising anthropometric and behavioural CVH variables (body mass index, smoking, diet, physical activity, and sleep) was derived in an Australian cohort (n=1801) measured in childhood (age 7-15 years) and at least once in adulthood, on average 20, 25, and 30 years later. Stroke markers hypertension, carotid plaque, carotid intima-media thickness (cIMT), stiffness index (SI), young elastic modulus (YEM), and carotid artery distensibility (CAD) were assessed at the last adult visit. Group-based trajectory modelling identified CVH trajectories with a high score denoting better CVH. Log-binomial and linear regressions examined the association, adjusting for sociodemographic confounders.

Results: Four distinct behavioural CVH trajectories were identified: high declining (n=143, 9.5%), average declining (n=660, 34.8%), improving to high (n=156, 12%), and consistently high (n=842, 43.8%). Compared with the consistently high trajectory, the high declining trajectory doubled the risk of hypertension (RR=2.22, 95% CI: 1.73, 2.85) and high cIMT (RR=2.36, 95% CI: 1.46, 3.80); the average declining trajectory showed greater risk of hypertension (RR=1.65, 95% CI: 1.34, 2.02). No significant associations were found between CVH trajectory and CAD, carotid plaque, SI or YEM. Both improving to high and consistently high trajectories were associated with lower risk of cIMT and hypertension.

Conclusion: Deterioration in behavioural CVH from childhood to adulthood was associated with a higher risk of cIMT and hypertension in mid-adulthood. Favourable behavioural CVH trajectories across the life course conferred vascular health benefits.