The influence of adolescent body mass index, physical activity, and tobacco use on blood pressure and cholesterol in young adulthood.

摘要

PURPOSE: To test the independent influences of adolescent tobacco use, physical activity/inactivity, and body mass index (BMI) on young adult cardiovascular risk factors. METHODS: This is a prospective cohort study using data from Waves I and III of the National Longitudinal Study of Adolescent Health (Add Health) (N = 14,322). We tested whether Wave I tobacco use, physical activity/inactivity, and BMI predicted self-report of being diagnosed with high blood pressure (BP) or high cholesterol by Wave III, while controlling for gender, age, race/ethnicity, use of healthcare, and Wave III tobacco use, physical activity/inactivity, BMI. RESULTS: Among young adults aged 18-26, 5.37% report high BP and 4.28% high cholesterol. Obese adolescents are more likely to report high BP by young adulthood than normal-weight adolescents, independent of all control variables including BMI in young adulthood (adjusted odds ratio [aOR] = 1.96; 95% confidence interval = [1.50-2.57]). Overweight and obese adolescents are more likely to report high cholesterol by young adulthood than normal-weight adolescents, independent of all control variables including BMI in young adulthood (aOR = 1.47 [1.14-1.90] and 2.05 [1.44-2.91], respectively). Adolescent tobacco use and physical activity/inactivity do not independently predict reported high BP or cholesterol. CONCLUSIONS: The odds of overweight and obese adolescents reporting a diagnosis for two cardiovascular risk factors by young adulthood are 1.5 to two times higher than normal-weight adolescents, regardless of BMI in young adulthood. The impact of transient and sustained increases in adolescent BMI on the evolution of cardiovascular risk warrants further investigation.