Influence of early-lifebody mass index and systolic blood pressure on left ventricle in adulthood - The Cardiovascular Risk in Young Finns Study.

BACKGROUND: Increased left ventricular mass (LVM) predicts cardiovascular eventsandmortality. The objective of this study was to determine whether early-life exposures to body mass index (BMI) and systolic blood pressure (SPB)affectthe left ventricular structure in adulthood.

METHODS: We usedlongitudinal datafrom a31-year follow-up to examine the associations betweenearly-life (between ages 6-18)BMI and SPBon LVM inanadult population (N = 1,864,aged 34-49). The burden of early-lifeBMI and SBPwasdefined asarea under the curve.

RESULTS: After accounting for contemporary adult determinants of LVM,early-life BMI burden associated significantly with LVM (3.61g/SD increase in early-life BMI; [1.94 - 5.28], p < 0.001). Overweight in early-life (age- and sex-specific BMI values corresponding to adult BMI >25kg/m2 ) associated with4.7% (2.5-6.9%, p < 0.0001) higher LVM regardless of BMI status inadulthood. Overweight in early-lifecombined with obesity in adulthood(BMI >30kg/m2 )resulted in a21% (17.3-32.9%, p < 0.0001)increase in LVM. Higher early-life BMI wasassociated with a risk of developing eccentric hypertrophy. The burden of early-lifeSPB was not associated with adult LVM or left ventricularremodeling.

CONCLUSIONS: High BMI in early-life confers a sustained effect on LVM and the risk for eccentric hypertrophy independently of adulthood risk factors. Key messages: Excess in BMI in early-lifehas an independent effect on LVM and the risk of developing eccentric hypertrophy regardless of overweight status in adulthood. Systolic blood pressure levels in early-life did not have an independent effect onLVM or cardiac remodeling. The clinical implicationof this study is that primary prevention of obesity in early-life may prevent the development of high LVM and eccentric hypertrophy.