Risk of cardiovascular disease measured by carotid intima-media thickness at age 49-51: lifecourse studyBMJ 2000; 320 doi: https://doi.org/10.1136/bmj.320.7230.273 (Published 29 January 2000) Cite this as: BMJ 2000;320:273
- Douglas Lamont, senior research associate in epidemiology ()a,
- Louise Parker, senior lecturer in epidemiologya,
- Martin White, senior lecturer in public healthb,
- Nigel Unwin, senior lecturer in epidemiologybc,
- Stuart M A Bennett, clinical research associatec,
- Melanie Cohen, research associatea,
- David Richardson, consultantd,
- Heather O Dickinson, senior research associatea,
- Ashley Adamson, lecturere,
- K G M Alberti, professorc,
- Alan W Craft, professora
- a Department of Child Health, University of Newcastle, Sir James Spence Institute of Child Health, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP
- b Department of Epidemiology and Public Health, School of Health Care Sciences, Medical School, University of Newcastle, Newcastle upon Tyne NE1 4HH
- c Department of Medicine, Medical School, University of Newcastle
- d Department of Radiology, Royal Victoria Infirmary, Newcastle
- e Human Nutrition Research Centre, University of Newcastle
- Correspondence to: D Lamont
- Accepted 11 November 1999
Objective: To quantify the direct and indirect effects of fetal life, childhood, and adult life on risk of cardiovascular disease at age 49–51 years.
Design: Follow up study of the “Newcastle thousand families” birth cohort established in 1947.
Participants: 154 men and 193 women who completed a health and lifestyle questionnaire and attended for clinical examination between October 1996 and December 1998.
Main outcome measures: Correlations between mean intima-media thickness of the carotid artery (carotid intima-media thickness) and family history, birth weight, and socioeconomic position around birth; socioeconomic position, growth, illness, and adverse life events in childhood; and adult socioeconomic position, lifestyle, and biological risk markers. Proportions of variance in carotid intima-media thickness that were accounted for by each stage of the lifecourse.
Results: Socioeconomic position at birth and birth weight were negatively associated with carotid intima-media thickness, although only social class at birth in women was a statistically significant covariate independent of adult lifestyle. These early life variables accounted directly for 2.2% of total variance in men and 2.0% in women. More variation in carotid intima-media thickness was explained by adult socioeconomic position and lifestyle, which accounted directly and indirectly for 3.4% of variance in men (95% confidence interval 0.5% to 6.2%) and 7.6% in women (2.1% to 13.0%). Biological risk markers measured in adulthood independently accounted for a further 9.5% of variance in men (2.4% to 14.2%) and 4.9% in women (1.6% to 7.4%).
Conclusions: Adult lifestyle and biological risk markers were the most important determinants of the cardiovascular health of the study members of the Newcastle thousand families cohort at age 49–51 years. The limited overall effect of early life factors may reflect the postwar birth year of this cohort.
Funding The current study was funded by the Wellcome Trust. Funding has also been provided by the Sir James Knott Trust (1992–5) and by the former Northern regional health authority (1993–5).
Competing interests None declared.
website extra Additional acknowledgments and a table detailing the representativeness of the cohort by weight and social class at birth appear on the BMJ's website www.bmj.com
- Accepted 11 November 1999