A newly concluded long-term study has reported that children whose parents have poor cardiometabolic health are more likely to develop early signs of heart damage as they grow into adulthood, even when they appear healthy in their teenage years.
The study, published in the European Journal of Preventive Cardiology, found that a parental history of conditions such as high blood pressure, diabetes, and abnormal cholesterol levels significantly accelerates harmful changes in the heart structure of their offspring over time.
Co-led by physician and associate professor of Clinical Epidemiology and Child Health, Andrew Abaje and Douglas Corsi, a Doctoral Researcher at the University of Eastern Finland, who noted that these changes begin silently in adolescence and continue to worsen into early adulthood, raising concerns about the long-term cardiovascular health of young people with inherited or family-related risk.
The research followed participants for 24 years using data from the Avon Longitudinal Study of Parents and Children (ALSPAC), a large population-based cohort. They assessed the heart structure and function of the participants at ages 17 and 24 using echocardiography — an ultrasound scan that allows doctors to see how the heart looks and works without surgery. Parents’ medical histories were also reviewed to determine the presence of cardiometabolic conditions.
Their findings showed that left ventricular hypertrophy, a condition in which the heart’s main pumping chamber becomes abnormally thickened, was already present in some participants by late adolescence.
At age 17, about 1.4 per cent of participants showed signs of this condition. By age 24, the proportion had increased to 2.4 per cent.
Abaje and his group reported that young people with a positive family history of cardiometabolic disease experienced a much faster progression of this heart abnormality. They found that between ages 17 and 24, the risk of developing left ventricular hypertrophy doubled among participants whose parents had cardiometabolic conditions, compared with those without such a family history.
The researchers explained that left ventricular hypertrophy is clinically important because a thickened heart muscle has to work harder to pump blood and over time, this strain increases the risk of serious conditions such as heart failure, heart attacks, and premature death later in life.
In addition to heart muscle thickening, the study examined left ventricular mass, a measure of the size and weight of the heart’s main pumping chamber. The authors reported that left ventricular mass increased more rapidly among participants with a parental history of cardiometabolic disease, indicating sustained stress on the heart even in early adulthood.
After adjusting for factors such as sex, body size, socioeconomic background, smoking, physical activity, blood pressure, cholesterol levels, diet, and other cardiometabolic risks, the researchers found that family history remained a strong and independent predictor of worsening heart structure. They associated each additional cardiometabolic condition in parents with progressively higher odds of developing left ventricular hypertrophy in offspring.
“Adolescence is a critical window in the evolution of cardiometabolic diseases, and the faster cardiac damage progression among those with a family history of cardiometabolic diseases raises significant concerns, necessitating a special focus. There is a critical twenty-year window between mid-twenties and mid-forties to prevent premature heart attacks in midlife,” Abaje explained.
The study also explored why this relationship exists. The researchers reported that higher fasting blood sugar levels, an indicator of how the body processes glucose, explained about 10 per cent of the link between parental cardiometabolic disease and increased heart mass in offspring. However, other factors such as cholesterol levels, blood pressure, smoking, and diet did not significantly explain the association once all variables were considered together.
They noted that family history reflects more than shared lifestyle habits. It also captures inherited genetic risk and long-term exposure to subtle metabolic changes that may not be obvious during routine medical check-ups. These hidden risks, the group explained, may quietly influence heart development over many years.
They also reported that an increase of 10 grams per square metre in left ventricular mass has been associated with a significantly higher risk of cardiovascular death in older adults, underscoring the potential long-term consequences of the changes observed in young people.
The researchers further estimated the population-level impact of parental cardiometabolic disease. They reported that for every 59 to 60 adolescents with a positive family history, one additional case of left ventricular hypertrophy was likely to occur by early adulthood, a burden that could accumulate significantly over time.
The study concluded that apparently healthy adolescents and young adults with a parental history of cardiometabolic disease face a substantially increased risk of early heart damage.
Abaje noted that identifying such individuals early could allow for targeted prevention strategies aimed at reducing long-term exposure to cardiometabolic risks.
“Health policies could encourage the general population to examine their blood pressure, cholesterol and glucose levels, at least once every five to ten years starting in late adolescence,” he added.
