Cardiovascular Health at Age 5 Years: Distribution, Determinants, and Association With Neurodevelopment

Rachel E Climie; Muriel Tafflet; Thomas van Sloten; Blandine de Lauzon-Guillain; Jonathan Y Bernard; Patricia Dargent-Molina; Sabine Plancoulaine; Sandrine Lioret; Xavier Jouven; Marie-Alines Charles; Barbara Heude; Jean-Philippe Empana

doi:10.3389/fped.2022.827525

Cardiovascular Health at Age 5 Years: Distribution, Determinants, and Association With Neurodevelopment

Front Pediatr. 2022 Apr 11:10:827525. doi: 10.3389/fped.2022.827525. eCollection 2022.

Authors

Affiliations

¹ Université de Paris, Inserm, U970, Paris Cardiovascular Research Center (PARCC), Integrative Epidemiology of Cardiovascular Disease, Paris, France.
² Menzies Institute for Medical Research, University of Tasmanian, Hobart, TAS, Australia.
³ Sports Cardiology, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.
⁴ Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France.
⁵ Department of Internal Medicine, Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht, Netherlands.
⁶ Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore.

Abstract

Background: Early childhood may represent an opportune time to commence primordial prevention of cardiovascular disease (CVD, i.e., prevention of risk factors onset), but epidemiological evidence is scarce. We aimed to examine the distribution and parental and early life determinants of ideal cardiovascular health (CVH) in children up to 5 years and to compare the level of cognitive development between children with and without ideal CVH at age 5 years.

Methods: Using data from the Etude sur les déterminants pré et post natals précoces du Développement psychomoteur et de la santé de l'Enfant (EDEN) study, a French population-based mother-child cohort study, CVH was examined in children at 5 years of age based on the American Heart Association CVH metrics (ideal body mass index, physical activity, diet, blood pressure, cholesterol and glucose levels, and passive smoking, considered in sensitivity analysis only). Children were categorized as having ideal (five to six ideal metrics) or non-ideal CVH (<5 ideal metrics). Intelligence quotient (IQ) at age 5 years was assessed using the French version of the Wechsler Preschool and Primary Scale of Intelligence.

Results: Among the 566 children (55% boys), only 34% had ideal CVH. In fully adjusted logistic regression, boys compared to girls (OR = 1.77, 95% CI 1.13-2.78), children with intermediate (1.77, 1.05-2.98) or ideal (2.58, 1.38-4.82) behavioral CVH at age 3 years and children who spent < 30 min/day watching television (1.91, 1.09-3.34) at age 3 years were more likely to have ideal CVH at age 5 years. At age 5 years, there was a significant 2.98-point difference (95% CI 0.64-5.32) in IQ between children with and without ideal biological CVH after adjusting for confounders.

Conclusion: This study highlights that only a third of children aged 5 years had ideal CVH and identified modifiable determinants of ideal CVH and is suggestive of an association between CVH and neurodevelopment at a young age.

Keywords: cardiovascular disease; childhood; determinants; neurodevelopment; primordial prevention.