0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Original Investigation | Adolescent and Young Adult Health

Childhood Psychosocial Factors and Coronary Artery Calcification in Adulthood The Cardiovascular Risk in Young Finns Study

Markus Juonala, MD, PhD1,2,3; Laura Pulkki-Råback, PhD4,5,6; Marko Elovainio, PhD5,7; Christian Hakulinen, PhD5; Costan G. Magnussen, PhD8,9; Matthew A. Sabin, MD, PhD3,10; David P. Burgner, MD, PhD3,10,11; David L. Hare, DPM, FRACP12; Olli Hartiala, MD, PhD8; Heikki Ukkonen, MD, PhD13; Antti Saraste, MD, PhD14,13; Sami Kajander, MD, PhD15; Nina Hutri-Kähönen, MD, PhD16; Mika Kähönen, MD, PhD17; Irina Rinta-Kiikka, MD, PhD18; Tomi Laitinen, MD, PhD19; Sakari Kainulainen, MD, PhD20; Jorma S. A. Viikari, MD, PhD1,2; Olli T. Raitakari, MD, PhD8,21
[+] Author Affiliations
1Department of Medicine, University of Turku, Turku, Finland
2Division of Medicine, Turku University Hospital, Turku, Finland
3Murdoch Childrens Research Institute and Royal Children’s Hospital, Melbourne, Australia
4Helsinki Collegium for Advanced Studies, University of Helsinki, Helsinki, Finland
5Unit of Personality, Work and Health, Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland
6Helsinki Collegium for Advanced Studies, University of Helsinki, Helsinki, Finland
7National Institute for Health and Welfare, Helsinki, Finland
8The Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
9Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia
10Department of Pediatrics, University of Melbourne, Melbourne, Australia
11Monash University, Melbourne, Australia
12Department of Medicine and Cardiology, University of Melbourne, Melbourne, Australia
13The Institute of Clinical Medicine, University of Turku, Turku, Finland
14Heart Center, Turku University Hospital, Turku, Finland
15Division of Imaging, Turku University Hospital, Turku, Finland
16Department of Pediatrics, University of Tampere, Tampere University Hospital, Tampere, Finland
17Department of Clinical Physiology, University of Tampere, Tampere University Hospital, Tampere, Finland
18Department of Radiology, University of Tampere, Tampere University Hospital, Tampere, Finland
19Department of Clinical Physiology, University of Eastern Finland, Kuopio University Hospital, Kuopio, Finland
20Department of Radiology, University of Eastern Finland, Kuopio and University Hospital, Kuopio, Finland
21Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
JAMA Pediatr. 2016;170(5):466-472. doi:10.1001/jamapediatrics.2015.4121.
Text Size: A A A
Published online

Importance  There is increasing evidence supporting the importance of psychosocial factors in the pathophysiology of atherosclerotic disease. They have been shown to be associated with the population attributable risk for myocardial infarction.

Objective  To determine if a score of favorable childhood psychosocial factors would be associated with decreased coronary artery calcification in adulthood.

Design, Setting, and Participants  The analyses were performed in 2015 using data gathered in 1980 and 2008 within the longitudinal Cardiovascular Risk in Young Finns Study. The data source consisted of 311 individuals who had psychosocial factors measured at ages 12 years to 18 years and coronary artery calcification measured 28 years later in adulthood. The summary measure of psychosocial factors in childhood comprised measures of socioeconomic factors, emotional factors, parental health behaviors, stressful events, self-regulation of the child, and social adjustment of the child.

Main Outcomes and Measures  Coronary artery calcification at ages 40 years to 46 years.

Results  Of the 311 participants, 48.2% were men. Of the participants, 55 (17.7%) had some calcium observed in their coronary arteries. A 1-SD increase in a favorable summary score of childhood psychological factors was associated with an adulthood coronary artery calcification probability of 0.85 (95% CI, 0.76-0.95) (P = .006). This inverse relationship remained significant after adjustment for age, sex, and conventional childhood risk factors (0.85; 95% CI, 0.74-0.97; P = .02) or for age, sex, adulthood conventional cardiovascular risk factors, socioeconomic status, social support, and depressive symptoms (0.83; 95% CI, 0.71-0.97; P = .02).

Conclusions and Relevance  In this longitudinal study, we observed an independent association between childhood psychosocial well-being and reduced coronary artery calcification in adulthood. A positive childhood psychosocial environment may decrease cardiovascular risk in adulthood and may represent a potentially modifiable risk determinant.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Figures

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

796 Views
0 Citations
×

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles
Jobs
JAMAevidence.com

Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice, 3rd ed
An Illustration of Bias and Random Error

Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice, 3rd ed
An Illustration of Bias and Random Error

brightcove.createExperiences();