Identifying early life predictors of adult carotid forward compression wave intensity in the Raine cohort

The characteristics of pulse waves transmitted through the carotid arteries are suggestive of cerebrovascular health in humans. This study aimed to identify whether risk factors throughout childhood, adolescence, and early adulthood were associated with forward compression wave intensity (FCWI) in the common carotid artery in adults aged 28 yr. Systolic blood pressure (SBP), body mass index (BMI), and fasting blood glucose (FBG) measured at multiple time points when participants were between 8 and 20 yr were included in a group-based trajectory-modeling analysis. At age 28 yr, FCWI was measured in 402 (M = 206, F = 196) participants following a duplex ultrasound assessment of the common carotid artery. Differences in FCWI between each trajectory group for males and females were tested separately. In males, four parallel trajectory groups were identified for BMI, three for SBP, and two for FBG. In females, three parallel trajectory groups were identified for BMI, SBP, and FBG. In males, higher BMI (P = 0.002), SBP (P = 0.001), and FBG (P = 0.002) from ages 8-20 yr were associated with greater FCWI at age 28 yr. In females, no associations were found between FCWI at age 28 yr and trajectory groups for BMI (P = 0.185), or FBG (P = 0.070), although the healthy SBP group had slightly higher FCWI than the lowest SBP group (P = 0.008). Risk factor profile throughout the developmental years was associated with higher FCWI in the carotid artery at age 28 yr in males. This intermediate physiological marker may be a contributor to the age- and risk factor-related progression of cognitive decline and cerebrovascular disease in later life.NEW & NOTEWORTHY Elevated forward compression wave intensity in the carotid artery is associated with accelerated cognitive decline in middle- and older-aged men. This study indicates that elevated blood pressure, body weight, and fasting blood glucose throughout childhood and adolescence are associated with greater forward compression wave intensity at age 28 yr in males. This may provide novel mechanistic insight into sex-specific risk factor profiles and may guide early life prevention strategies.