Positive psychosocial factors in childhood may decrease cardiovascular risk in adulthood

A longitudinal study that followed participants for 28 years found that children with favorable psychosocial factors were less likely to have coronary artery calcification (CAC) and cardiovascular risk factors in adulthood.

Lead researcher Markus Juonala, MD, PhD, of the University of Turku in Finland, and colleagues published their results online in JAMA Pediatrics on March 14.

“From the clinical perspective, our findings underscore the need for increased awareness of promoting positive psychosocial health in childhood,” they wrote. “Because data on many of the factors used in the summative score could be readily gathered at diverse health service encounters, these data might be used in targeted family interventions for primary prevention, especially in those at greatest risk.”

The researchers noted that previous research found CAC was a predictive marker of subclinical atherosclerosis and was associated with coronary heart disease.

In this study, they examined 311 participants from the Cardiovascular Risk in Young Finns study who had complete data on childhood psychosocial factors in 1980 and CAC imaging performed in 2008. The first cross-sectional survey was conducted in 1980 and then follow-up studies were performed at three to nine year intervals. In 2008, participants underwent a cardiac CT to measure CAC.

The researchers assessed the following six psychosocial factors: socioeconomic environment, emotional environment, parental health behaviors, stressful events, self regulation and social adjustment of the child. Parents assessed the factors in 1980 via a standardized questionnaire. They then combined the six psychosocial factors into one summary score.

The mean age at baseline was 14.5 years old, and the range of ages was 12 to 18 years old. Of the participants, 48.2 percent were male, while 17.7 percent had CAC. Further, 9.0 percent of participants had a CAC score of 1 to 10; 6.5 percent had a CAC score of 11 to 100; and 2.2 percent had a CAC score of greater than 100.

The researchers mentioned the childhood psychosocial factor score was inversely associated with the prevalence of CAC as an adult even after adjusting for age, sex and conventional childhood risk factors. The relationship was the same after adjusting for age, sex and adulthood risk factors such as body mass index, lipids, blood pressure, glucose, smoking, annual income, social support and depressive symptoms.

The study had a few limitations, according to the authors, including that they only had data on childhood psychosocial factors for a subcohort of the study, which may compromise its statistical power. They added that the childhood psychosocial factors were developed three decades ago and were not current standard measures. Further, parents self-reported their childrens’ psychosocial factors, which may be subject to bias.

“We have shown an independent association between childhood psychosocial factors and CAC in adulthood,” they wrote. “This finding suggests that favorable childhood psychosocial environment may decrease cardiovascular risk in adulthood. Strategies that aim to optimize psychological well-being may be beneficial in reducing adult cardiovascular disease.”