02405nas a2200229 4500008004100000022001400041245010300055210006900158260001500227300001400242490000700256520169400263100002901957700002201986700001602008700002202024700002102046700002902067700002302096700002002119856003602139 2019 eng d a1464-368500aUse of a pooled cohort to impute cardiovascular disease risk factors across the adult life course.0 aUse of a pooled cohort to impute cardiovascular disease risk fac c2019 06 01 a1004-10130 v483 a

BACKGROUND: In designing prevention strategies, it may be useful to understand how early and midlife cardiovascular disease risk factor (CVDRF) exposures affect outcomes that primarily occur in mid to late life. Few single US cohorts have followed participants from early adulthood to late life.

METHODS: We pooled four prospective cohorts that represent segments of the adult life course, and studied 15 001 White and Black adults aged 18 to 95 years at enrollment. We imputed early and midlife exposure to body mass index (BMI), glucose, lipids and blood pressure (BP). CVDRF trajectories were estimated using linear mixed models. Using the best linear unbiased predictions, we obtained person-specific estimates of CVDRF trajectories beginning at age 20 until each participant's end of follow-up. We then calculated for each CVDRF, summary measures of early and midlife exposure as time-weighted averages (TWAs).

RESULTS: In the pooled cohort, 33.7% were Black and 54.8% were female. CVDRF summary measures worsened in midlife compared with early life and varied by sex and race. In particular, systolic and diastolic BP were consistently higher over the adult life course among men, and BMI was higher among Blacks, particularly Black women. Simulation studies suggested acceptable imputation accuracy, especially for the younger cohorts. Correlations of true and imputed CVDRF summary measures ranged from 0.53 to 0.99, and agreement ranged from 67% to 99%.

CONCLUSIONS: These results suggest that imputed CVDRFs may be accurate enough to be useful in assessing the effects of early and midlife exposures on later life outcomes.

1 aHazzouri, Adina, Zeki Al1 aVittinghoff, Eric1 aZhang, Yiyi1 aPletcher, Mark, J1 aMoran, Andrew, E1 aBibbins-Domingo, Kirsten1 aGolden, Sherita, H1 aYaffe, Kristine uhttps://chs-nhlbi.org/node/8208