Figure 2. Associations Between Childhood, Adult, and Childhood Plus Adult Non–HDL-C Z Scores and Adult CVD Events.

CVD indicates cardiovascular disease; non–HDL-C, non–high-density lipoprotein cholesterol. Incident CVD included the first occurrence of adjudicated myocardial infarction, stroke, transient ischemic attack, ischemic heart failure, angina, peripheral artery disease, carotid intervention, abdominal aortic aneurysm, or coronary revascularization, as well as CVD deaths. There were 147 incident CVD events (5121 participants; incidence rate, 3.23 per 1000 person-years).

^aHazard ratios are reported per 1-unit increase in z scores; cohort-stratified cause-specific hazard models were used and analyses were weighted by the inverse of probability of being included in analysis and were adjusted for sex, Black race, childhood smoking, mean age at and calendar year of childhood measurement, childhood mean age- and sex-specific z scores for body mass index and systolic blood pressure, adult smoking, and change in z scores for body mass index and systolic blood pressure between childhood and adulthood.

^bVariables in parentheses are exposures of interest in each model. Childhood non–HDL-C levels at each visit were standardized as age- and sex-specific z scores within each age and sex stratum. The mean of resulting z scores across childhood measurements for each participant was then calculated to obtain a single mean z score for analysis (eAppendix in Supplement 1). The same approach was used to obtain adult non–HDL-C z scores. Change in z score was calculated by subtracting childhood mean z score from adult mean z score.