RATIONALE Data are limited regarding the influence of life-course cumulative burden of increased body mass index (BMI) and elevated blood pressure (BP) on the progression of left ventricular (LV) geometric remodeling in midlife. OBJECTIVE To investigate the dynamic changes in LV mass and LV geometry over 6.4 years during midlife and to examine whether the adverse progression of LV geometric remodeling is influenced by the cumulative burden of BMI and BP from childhood to adulthood. METHODS AND RESULTS The study consisted of 877 adults (604 whites and 273 blacks; 355 males; mean age=41.4 years at follow-up) who had 5 to 15 examinations of BMI and BP from childhood and 2 examinations of LV dimensions at baseline and follow-up 6.4 years apart during adulthood. The area under the curve (AUC) was calculated as a measure of long-term burden (total AUC) and trends (incremental AUC) of BMI and systolic BP (SBP). After adjusting for age, race, sex, smoking, alcohol drinking, and baseline LV mass index, the annual increase rate of LV mass index was associated with all BMI measures (β=0.16-0.36, P<0.05 for all), adult SBP (β=0.07, P=0.04), and total AUC of SBP (β=0.09, P=0.01) but not with childhood and incremental AUC values of SBP. All BMI and SBP measures (except childhood SBP) were significantly associated with increased risk of incident LV hypertrophy, with odds ratios of BMI (odds ratio=1.85-2.74, P<0.05 for all) being significantly greater than those of SBP (odds ratio=1.09-1.34, P<0.05 for all except childhood SBP). In addition, all BMI measures were significantly and positively associated with incident eccentric and concentric LV hypertrophy. CONCLUSIONS Life-course cumulative burden of BMI and BP is associated with the development of LV hypertrophy in midlife, with BMI showing stronger associations than BP. Visual Overview: An online visual overview is available for this article.

中文翻译：

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中年左心室质量和几何学进展的体重指数和血压的生命历程累积负担：Bogalusa 心脏研究。

基本原理 关于增加体重指数 (BMI) 和血压升高 (BP) 对中年左心室 (LV) 几何重构进展的生命历程累积负担的影响的数据有限。目的 调查 LV 质量和 LV 几何在中年期间 6.4 年的动态变化，并检查 LV 几何重构的不利进展是否受到从儿童期到成年期 BMI 和 BP 累积负担的影响。方法和结果 该研究包括 877 名成年人（604 名白人和 273 名黑人；355 名男性；随访时平均年龄 = 41.4 岁），他们从儿童期开始接受 5 至 15 次 BMI 和 BP 检查，并在基线和 2 次左室尺寸检查成年期随访间隔 6.4 年。曲线下面积 (AUC) 被计算为衡量 BMI 和收缩压 (SBP) 的长期负担 (总 AUC) 和趋势 (增量 AUC)。在调整年龄、种族、性别、吸烟、饮酒和基线 LV 质量指数后，LV 质量指数的年增长率与所有 BMI 测量值相关（β=0.16-0.36，所有 P<0.05）、成人 SBP (β=0.07, P=0.04) 和 SBP 的总 AUC (β=0.09, P=0.01) 但与儿童期和 SBP 的增量 AUC 值无关。所有 BMI 和 SBP 测量值（儿童 SBP 除外）均与 LV 肥大事件风险增加显着相关，BMI 的优势比（优势比 = 1.85-2.74，所有 P<0.05）显着高于 SBP 的优势比（优势比= 1.09-1.34，除儿童期 SBP 外，所有患者的 P<0.05）。此外，所有 BMI 测量值均与偶发的偏心和同心 LV 肥大呈显着正相关。结论 BMI 和 BP 的生命历程累积负担与中年 LV 肥大的发展相关，BMI 显示出比 BP 更强的相关性。视觉概览：本文提供在线视觉概览。