Cardiovascular Health Trajectories and Elevated C‐Reactive Protein: The CARDIA Study

BACKGROUND: The relationship between long‐term cardiovascular health (CVH) patterns and elevated CRP (C‐reactive protein) in late middle age has yet to be investigated. We aimed to assess this relationship. METHODS AND RESULTS: Individual CVH components were measured in 4405 Black and White men and women (aged 18–30 years at baseline) in the CARDIA (Coronary Artery Risk Development in Young Adults) study at 8 examinations over 25 years. CRP was measured at 4 examinations (years 7, 15, 20, and 25). Latent class modeling was used to identify individuals with similar trajectories in CVH from young adulthood to middle age. Multivariable Poisson regression models were used to assess the association between race‐specific CVH trajectories and prevalence of elevated CRP levels (>3.0 mg/L) after 25 years of follow‐up. Five distinct CVH trajectories were identified for each race. Lower and decreasing trajectories had higher prevalence of elevated CRP relative to the highest trajectory. Prevalence ratios for elevated CRP in lowest trajectory groups at year 25 were 2.58 (95% CI, 1.89–3.51) and 7.20 (95% CI, 5.09–10.18) among Black and White people, respectively. Prevalence ratios for chronically elevated CRP (elevated CRP at 3 or more of the examinations) in the lowest trajectory groups were 8.37 (95% CI, 4.37–16.00) and 15.89 (95% CI, 9.01–28.02) among Black and White people, respectively. CONCLUSIONS: Lower and decreasing CVH trajectories are associated with higher prevalence of elevated CRP during the transition from young adulthood to middle age.