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The long-term evolution of young adults’ risk profiles for CVD

Die langfristige Evolution des kardiovaskulären Risikoprofils bei jungen Erwachsenen

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Abstract

Introduction

Prospective epidemiological studies on the evolution of the cardiovascular risk-profile in young adulthood have not been published so far for Germany.

Methods

In 1975 a sample of 5 924 adolescents aged 15–19 was examined at schools in the city of Cologne. After reexamination in 1976 und 1980, a long-term follow-up was carried out with those still living in the city and thus being easily available in 1990. For that purpose 613 former adolescents were identified and invited to the university hospital; 210 young adults (143 males (M) and 67 females (F)) now 30 – 34 years old were examined for main cardiovascular risk factors using the same methodology as in 1975.

Results

Whereas systolic and diastolic (phase 5) blood pressures (SBP and DBF) did not change very much, the means of total cholesterol (CHOL) and body-mass (BMI) increased considerably (CHOL from 158 mg/dl in 1975 to 195 in 1990 (M) and from 176 to 199 (F); BMI from 20.8 kg/sqm to 24.1 (M) and from 20.6 to 22.7 (F)). Pearson correlations increased especially between SBP and DBP (from .21 to .52 (M) and from .45 to .65 (F)) and between DBP and BMI (from .16 to .26 (M) and from .25 to .40 (F)). Autocorrelations remained quite high over the entire period (SBP .43, DBP .48, CHOL .42 and BMI.71 (M) and .51, .36, .49 and .81 (F)). Regression analysis shows that 51 % of the variance of SBP and of DBP in 1990 can be explained mainly by the foregoing measurements, but only 24 % of the variance of total cholesterol. Risk patterns in terms of aggregation of risk factors and risk habits worsened considerably during the 15 years of observation.

Conclusion

Given the rarity of longitudinal risk factor observations in early adulthood, the Cologne data underline the considerable stability of cardiovascular risk factors also during this period of life and stress the importance of appropriate monitoring and intervention early in life.

Zusammenfassung

Einleitung

Zur Evolution des kardiovaskulären Risikoprofils im jungen Erwachsenenalter liegen aus Deutschland keine epidemi ologischen Untersuchungen vor. Methode: 5 924 Jugendliche zwischen 15 und 19 Jahren wurden 1975 in Kölner Schulen untersucht. Auf Nachuntersuchungen 1976 und 1980 folgte 1990 ein Langzeit-Follow-up der noch in Köln wohnhaften Probanden. 613 frühere Teilnehmer konnten identifiziert und in die Universitätsklinik Köln-Merheim eingeladen werden. 210 junge Erwachsene (143 Männer (M) und 67 Frauen (F))-jetzt im Alter von 30 bis 34-wurden mit der gleichen Methodik wie 1975 auf kardiovaskulare Risikofaktoren untersucht.

Ergebnisse

Während sich systolischer und diastolischer (5. Phase) Blutdruck (SBP und DBF) kaum veränderten, stiegen die Mittelwerte fär Gesamtcholesterin (CHOL) und Body-Mass-Index (BMI) deutlich an (CHOL von 158 mg/dl 1975 auf 195 mg/dl 1990 (M) und von 176 auf 199 (F); BMI von 20,8 kg/sqm auf 24,1 (M) und von 20,6 auf 22,7 (F)). Die Pearson-Korrelationskoeffizienten erhöhten sich v. a. zwischen SBP und DBF (von .21 auf .52 (M) und von .45 auf .65 (F)) sowie zwischen DBF und BMI von .16 auf .26 (M) und von .25 auf .40 (F)). Die Autokorrelationen blieben über das gesamte Follow-up hoch (SBP .43, DBP .48, CHOL .42 und BMI .71 (M) bzw. .51, .36, .49, .81 (F)). Die Regressionsanalyse weist aus, daß sich 51 % der Varianz von SBP und von DBP im Jahr 1990 durch die früheren Blutdruck-Meßwerte erklären lassen, aber nur 24 % der Varianz von CHOL. Das Risikoprofil i. S. aggregierter Risikofaktoren verschlechterte sich während der 15jährigen Beobachtungsperiode deutlich.

Schlußfolgerung

Langzeitbeobachtungen des kardiovaskulären Risikoprofils im jungen Erwachsenenalter sind selten; die Daten der Kölner Studie belegen die hohe Stabilität der einschlägigen Risikofaktoren auch in dieser Lebensperiode. Eine angemessene überwachung und ggf. Intervention im frühen Lebensalter ist indiziert.

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Correspondence to Ulrich Laaser.

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Laaser, U., Allhoff, P.G., Bönner, G. et al. The long-term evolution of young adults’ risk profiles for CVD. Z. f. Gesundheitswiss. 3, 145 (1995). https://doi.org/10.1007/BF02959990

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Keywords

  • precursors of atherosclerosis
  • long-term follow-up
  • early adulthood
  • blood pressure
  • cholesterol
  • smoking
  • body-mass

Schlüsselwörter

  • Frühindikatoren der Atherosklerose
  • Longitudinalstudie
  • junge Erwachsene
  • Blutdruck
  • Gesamtcholesterin
  • Rauchen
  • relatives Körpergewicht