684Childhood Risk Factors and Adult Cardiovascular Disease Outcomes The International Childhood Cardiovascular Cohort (i3C) Consortium

Background Atherosclerosis develops silently for decades before adult cardiovascular disease (aCVD) occurs. There is currently no evidence directly linking childhood risk factors to aCVD outcomes. Methods i3C is an international consortium of 7 cohorts involving 40,709 participants enrolled between 1970-95 in childhood (age 3-19) who underwent measurement for BMI, SBP, total cholesterol, and triglycerides, and smoking (the last mostly in adolescence). Participants were followed by direct contact and review of medical records or death registry ascertainment through adulthood in 2014-19. 20,560 participants were found and interviewed or had died in the approximately 40 years since enrollment; 738 had a CVD event, confirmed by medical record review (n = 449) or death certificate ICD code (n = 289). Results Estimated hazard ratios (HRs) for childhood risk factors and their confidence intervals are displayed in the table below. The CIs excluded 1.0 for all these variables in the univariable analysis and, although the HRs were reduced in multivariable analysis which included all of these risk factors, the CIs still excluded 1.0. Conclusion Exposure to CVD risk factors in youth predicts adult CVD with implications for primordial CVD prevention. Key messages Intervention to reduce CVD risk factors in childhood is likely to reduce risk of adult CVD

Abstract P183: Contribution Of Childhood Risk Factors To Sex Differences In Adult Carotid Imt And Plaques: The Childhood Determinants Of Adult Health Study

Background: Understanding the origins of sex differences in cardiovascular diseases (CVD) may help with prevention. We examined sex differences in carotid artery IMT and plaques in adulthood including the contribution of childhood risk factors. Methods: Boys and girls aged 7-15 years old from the Australian Schools Health and Fitness Survey in 1985 were followed up in the Childhood Determinants of Adult Health study at ages 36-49 years between 2014-19. Sex differences in adult carotid IMT and plaques, identified with 2D ultrasound of left and right carotid arteries, were examined with linear and log binomial regression, respectively. Childhood sociodemographic, psychosocial, health-related behavioural and biomedical risk factors that might contribute to sex differences in carotid IMT/plaques were identified with purposeful model building. Results: Among 1,286 men and women with vascular measurements of carotid IMT (53% women, mean carotid IMT 0.63 mm ± 0.09 standard deviation) women had thinner carotid IMT measurements than men (β coefficients -0.053 95% CI -0.063, -0.043). Adjusting for age standardised waist circumference (WC), waist/hip ratio (WHR), waist/height ratio (WHtR) and systolic blood pressure (SBP) in childhood reduced the sex difference of carotid IMT in adulthood (see Figure), but a significant sex-difference in carotid IMT remained. Women had a 42% lower risk of plaques than men (Relative Risk 0.58 95% CI 0.42, 0.79). School achievement levels, endurance/power fitness and SBP in childhood partially explained the sex difference in the prevalence of plaques at adulthood (see Figure) as the sex difference decreased and became statistically insignificant. Conclusion: Various factors in childhood had contributed to thicker carotid IMT and higher prevalence of carotid plaques in men compared to women. These findings suggest that the origins of adult sex differences in CVD may begin in childhood. There may be benefits of sex-specific primary prevention programs starting in childhood.

Predicting Adverse Events In A Forensic Psychiatric Population: a Developmental Approach

While adverse events such as inpatient violence, recidivism, and readmission to hospital are extremely common among individuals found not criminally responsible on account of mental disorder (NCRMD), very little is known about developmental risk factors that predict these adverse events in this population. Developmental risk factor research (RFR) focuses on childhood risk factors and later outcomes, and allows for establishing a timeline for events, experiences, and the onset of behaviours or illnesses. The present study is a retrospective file review of inpatients and outpatients at Forensic Mental Health Hospital in South Central Ontario who have been found NCRMD. Developmental risk factors that have been found to predict adverse events in criminal, psychiatric, and forensic psychiatric populations, and adverse events over the period of 1 year were coded. Overall, risk factors occurring in childhood did not predict adverse events. Risk factors occurring in adolescence, specifically trauma, abuse or neglect, predicted adverse events.

Predicting Adverse Events In A Forensic Psychiatric Population: a Developmental Approach

While adverse events such as inpatient violence, recidivism, and readmission to hospital are extremely common among individuals found not criminally responsible on account of mental disorder (NCRMD), very little is known about developmental risk factors that predict these adverse events in this population. Developmental risk factor research (RFR) focuses on childhood risk factors and later outcomes, and allows for establishing a timeline for events, experiences, and the onset of behaviours or illnesses. The present study is a retrospective file review of inpatients and outpatients at Forensic Mental Health Hospital in South Central Ontario who have been found NCRMD. Developmental risk factors that have been found to predict adverse events in criminal, psychiatric, and forensic psychiatric populations, and adverse events over the period of 1 year were coded. Overall, risk factors occurring in childhood did not predict adverse events. Risk factors occurring in adolescence, specifically trauma, abuse or neglect, predicted adverse events.