There exists well established evidence on the association between cardiovascular risk factors as early as in childhood and adolescence and later cardiovascular (CV) outcomes. However, heritable and environmental influences may have confounded to produce an overestimation of benefits of modifying those risk factors in previous studies. To better clarify the causal inference, a Swedish nationwide cohort study reviewed a chunk of data retrieved from linking different registries that involved more than 1 million young men with a follow-up of more than 20 years. Exposures were established from a series of objective measures inclusive of body mass index (BMI), cardiorespiratory fitness, blood pressure, handgrip strength and combined risk z score which was the combined effect of previously mentioned exposures. For outcomes, it simply adopted the fatal or non-fatal CV events recorded in national inpatient registry or death registry. One important feature that powers the study findings was sibling comparison to control for shared familiar factors. Among the five exposures, BMI stood out as the most associated individual risk factor for CVD, suggesting that even small improvements in BMI among adolescents could contribute to sizeable preventive effect against later CVD development after controlling for shared familial factors. Meanwhile interventions targeting physical fitness, including cardiorespiratory fitness and handgrip strength, might only yield benefits smaller than typically expected. The above findings have indicated clearly on the priority for policymakers and public health practitioners should go with for optimal prevention against the increasing CVD.

References

Ballin M, et al. JAMA Netw Open. 2023 Nov 1;6(11):e2343947.