Association of Pathobiologic Determinants of Atherosclerosis in Youth Risk Score and 15-year Change in Risk Score with Carotid Artery Intima-media Thickness in Young Adults (from the Cardiovascular Risk in Young Finns Study)

The Pathobiological Determinants of Atherosclerosis in Youth (PDAY) study of autopsy findings in subjects 15 to 34 years of age developed a risk score using coronary heart disease risk factors (gender, age, serum lipoprotein concentrations, smoking, hypertension, obesity, and hyperglycemia) to estimate the probability of advanced atherosclerotic lesions in the coronary arteries. The Cardiovascular Risk in Young Finns Study measured coronary heart disease risk factors in a population-based cohort in 1986 and 2001 and measured carotid artery intima-media thickness (IMT) with ultrasonography in 2001. We computed the PDAY risk score from risk factors measured in 1,279 subjects who were 12 to 24 years of age in 1986 and 27 to 39 years of age in 2001. The PDAY risk score early in life (i.e., 1986) and the change in risk score in the following 15 years (i.e., 1986 through 2001) were independent predictors of carotid artery intima-media thickness; the multiplicative effect of 1 point in the 1986 risk score was 1.008 (95% confidence interval 1.005 to 1.012) and the multiplicative effect of a 1-point increase between the 1986 and 2001 risk scores was 1.003 (95% confidence interval 1.001 to 1.006; multiplicative effect of 0.997 for a 1-point decrease). In conclusion, the change in risk score over time (decrease or increase) during adolescence and young adulthood, as well as the risk score early in life, are important predictors of atherosclerosis.